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RUSVM SAM 2 > Uvea > Flashcards

Uvea Flashcards

1
Q

What are the components of the uvea?

A

Anterior
- iris and ciliary body

Posterior
-choroid

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2
Q

What is the blood supply that encircles the iris?

A

Major arterial circle

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3
Q

What are the zones of the iris?

A

Ciliary zone

Iris collarette (persistent pupillary membranes arise from his junction)

Pupillary zone

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4
Q

What is a persistent pupillary membrane (PPM) ?

A

Incomplete absorption of embryonic vascular tissue and mesenchymal strands

Originating form iris collarette
- iris - iris

  • iris - lens (remnants can leave pigment on anterior lens capsule, often cause focal cataracts )
  • iris - cornea (can see from side, transversing anterior chamber and can result from scaring where they attach)
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5
Q

What is the function of the uvea?

A

Aqueous production
Maintenance of blood-ocular barrier (clear ocular media)
Light regulation
Accommodation

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6
Q

What are the components of the blood-ocular barrier ?

A

Blood-aqueous barrier

  • iris blood vessel endothelium
  • ciliary body epithelium

Blood-retinal barrier

  • retinal blood vessel endothelium
  • retinal pigment epithelium
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7
Q

What is the function of the blood-ocular barrier?

A

Prevent passage of protein and cells into the anterior chamber and posterior segment

Allows clear media for vision

Disruption of barrier = uveitis

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8
Q

What is the pathophysiology of inflammation of the uvea?

A

Increased blood supply

Increased vessel permeability

White blood cell migration

Breakdown of the blood-ocular barrier

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9
Q

What do you call inflammation of the iris and ciliary body?

A

Anterior uveitis (iridocyclitis)

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10
Q

What do you call inflammation of the choroid?

A

Posterior uveitis ( choroiditis)

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11
Q

What do you call inflammation of the entire uvea?

A

Panuveitis

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12
Q

What do you call inflammation of the entire uvea and intraocular contents?

A

Endophthalmitits

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13
Q

What do you call inflammation of all the ocular and intraocular structures?

A

Panophtalmitis

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14
Q

What clinical signs are seen with uveitis?

A 
Blepharospasm 
Epiphora 
Photophobia 
Red eye 
- ciliary flush
- episceral injection 
Corneal edema 
Miosis
Aqueous flare 
Hyphema 
Hypopyon 
Fibrin 
Keratic precipitates 
Swollen/thickened iris 
Iris hyperemia 
Rubeosis iridis 
Decreased intraocular pressure 
Active chorioretinal lesions
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15
Q

What causes the miosis seen with uveitis?

A

Inflammation due to prostaglandins

= causes pain from ciliary body spasm
= causes iris sphincter muscle contraction

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16
Q

What causes an aqueous flare?

A

Increased turbidity due to breakdown of the blood-aqueous barrier

Protein and cells in AC cause light scattering

Detected with very focal light source close to the cornea in a dark room

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17
Q

What do you call blood in the anterior chamber?

18
Q

What do you call WBC in the anterior chamber?

19
Q

What are keratic precipitates?

A

Inflammatory cells and fribrin adhered to corneal endothelium

20
Q

What is rubeosis iridis?

A

Neovascularization of iris surface (chronic)

21
Q

Why do you have a deceased ocular pressure with uveitis?

A

Inflammation driven by prostaglandins

Decreased aqueous humor production

Normal IOP is 10-20mmHG

22
Q

Why do you see active chorioretinal lesions with uveitis?

A

Breakdown of blood-retinal barrier

Hyporeflective, raised, and poorly circumscribed lesions

Retinal edema

Subretinal infiltrates/glaucoma

Retinal hemorrhage

Retinal detachment

Vitreous haze

23
Q

What are clinical signs of CHRONIC uveitis?

A

Posterior synechia

  • dyscoria (abnormally shaped pupil)
  • iris bombe (apposition of iris and lens prevents aqueous from flowing into posterior of anterior chamber)

Iris hyperpigmentation

Cataracts
Secondary glaucoma
Retinal detachments
Phthisis bulbi

24
Q

What are the types of uveitis?

A

Exogenous= external to the eye

  • blunt or perforating trauma
  • corneal ulceration

Endogenous
-infectious, neoplasia, metabolic, auto-immune, drug-induced

25
What are infectous causes of canine uveitis?
Prototheca (algae) Borrelia, brucella, lepto Aspergillosis, blasto, crypto, histo, coccidioides Angiostrongylus, baylisascaria, Diptera, drofilaria, toxocara Leishmania, neospora, toxo, trypanosoma Erhlichia, rickettsia Adenovirus, distemper, herpes
26
What type of infectious uveitis has pyogranulomatous inflammation and involves the posterior segment ?
Disseminated mycotic
27
What type of uveitis will you see migratory tracts in retina?
Intraocular nematodiasis
28
What type of uveitis is associated with vasculitis and retinal hemorrhage, thrombocytopenia, platelet dysfunction, and hypervisocity?
Rickettsial disease (Ehrlichia)
29
What are non-infectous causes of uveitis?
Immune mediated - idiopathic most commonly Metabolic - DM, hyperlipidemia, hypertension Neoplastic - histiocytic proliferative disease, hyperviscocity syndome, lymphosarcoma, melanoma Trauma
30
What is a lens induced uveitis?
Leakage of lens protein from a cataract Suspect in any red eye with a cataract
31
What is uveodermatologic syndrome?
Autoimmune disease directed against melanocytes Severe bilateral panuveitis Depigmentaion of iris and or choroid Ulceration and vitiligo of facial mucocutaneous junctions
32
What breed of dog gets pigmentary deposits on the lens an corneal endothelium, iris hperpigmentation, and uveal cysts ?
Golden retrievers
33
What are the infectious causes of feline uveitis ?
FIV, FeLV, FIP and toxo Also fungal Diptera And bacterial
34
What is likely the cause of a chorioretintitis with concurrency URI, swelling over the bridge of the nose, and cutaneous lesions
Cryptococcosis
35
How will you work up a canine uveitis case?
``` travel history PE CBC Chem UA Thoracic rads Tick titers Fungal titers ``` If hyphema present: Coag panel BP CBC
36
How will you work up a feline uveitis case?
``` Travel history PE CBC Chem UA Thoracic rads ``` FIV/FLV Toxo titer Fungal titers Hyphema: Coag BP CBC
37
What is the treatment of uveitis?
Primary cause (if known) All required anti-inflammatories (topical steroids +/- NSAIDS) Topical atropine +/- systemic corticosteroids OR systemic NSAIDS +/- systemic antimicrobials
38
What topical corticosteroids are appropriate for treatment of uveitis?
Prednisolone acetate Dexamethasone (neopolydex)
39
What topical NSAIDS are appropriate for treating uveitis?
Flurbiprofen Diclofenac Ketorolac Can be used with topical steroids
40
What causes of uveitis must you rule out before starting systemic corticosteroids?
Infectious causes Prednisone (canine) Prednisolone (cat)
41
What systemic NSAIDS are appropriate for treating uveitis?
Carprofen or Meloxicam (dog) Robenacoxib (cat)
42
What is are the benefits to using a topical mydratics for uveitis?
Atropine Reduce pain of ciliary body spasm Reduces risk of posterior synechia Stablilizes blood-ocular barrier

RUSVM SAM 2 (44 decks)

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