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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?

A

Hyphema

18
Q

What do you call WBC in the anterior chamber?

A

Hypopyon

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
Q

What are infectous causes of canine uveitis?

A

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
Q

What type of infectious uveitis has pyogranulomatous inflammation and involves the posterior segment ?

A

Disseminated mycotic

27
Q

What type of uveitis will you see migratory tracts in retina?

A

Intraocular nematodiasis

28
Q

What type of uveitis is associated with vasculitis and retinal hemorrhage, thrombocytopenia, platelet dysfunction, and hypervisocity?

A

Rickettsial disease (Ehrlichia)

29
Q

What are non-infectous causes of uveitis?

A

Immune mediated - idiopathic most commonly

Metabolic - DM, hyperlipidemia, hypertension

Neoplastic - histiocytic proliferative disease, hyperviscocity syndome, lymphosarcoma, melanoma

Trauma

30
Q

What is a lens induced uveitis?

A

Leakage of lens protein from a cataract

Suspect in any red eye with a cataract

31
Q

What is uveodermatologic syndrome?

A

Autoimmune disease directed against melanocytes

Severe bilateral panuveitis
Depigmentaion of iris and or choroid

Ulceration and vitiligo of facial mucocutaneous junctions

32
Q

What breed of dog gets pigmentary deposits on the lens an corneal endothelium, iris hperpigmentation, and uveal cysts ?

A

Golden retrievers

33
Q

What are the infectious causes of feline uveitis ?

A

FIV, FeLV, FIP and toxo

Also fungal
Diptera
And bacterial

34
Q

What is likely the cause of a chorioretintitis with concurrency URI, swelling over the bridge of the nose, and cutaneous lesions

A

Cryptococcosis

35
Q

How will you work up a canine uveitis case?

A 
travel history 
PE 
CBC 
Chem 
UA 
Thoracic rads 
Tick titers 
Fungal titers

If hyphema present:
Coag panel
BP
CBC

36
Q

How will you work up a feline uveitis case?

A 
Travel history 
PE 
CBC 
Chem 
UA 
Thoracic rads

FIV/FLV
Toxo titer
Fungal titers

Hyphema:
Coag
BP
CBC

37
Q

What is the treatment of uveitis?

A

Primary cause (if known)

All required anti-inflammatories (topical steroids +/- NSAIDS)
Topical atropine

+/- systemic corticosteroids OR systemic NSAIDS
+/- systemic antimicrobials

38
Q

What topical corticosteroids are appropriate for treatment of uveitis?

A

Prednisolone acetate

Dexamethasone (neopolydex)

39
Q

What topical NSAIDS are appropriate for treating uveitis?

A

Flurbiprofen
Diclofenac
Ketorolac

Can be used with topical steroids

40
Q

What causes of uveitis must you rule out before starting systemic corticosteroids?

A

Infectious causes
Prednisone (canine)
Prednisolone (cat)

41
Q

What systemic NSAIDS are appropriate for treating uveitis?

A

Carprofen or Meloxicam (dog)

Robenacoxib (cat)

42
Q

What is are the benefits to using a topical mydratics for uveitis?

A

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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