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Ophtho (sophomore) > Uveal dzs (Whitley) > Flashcards

Uveal dzs (Whitley) Flashcards

1
Q

Uveal tract

A
  • Vascular tunic of the eye
  • Three parts
    • Iris
    • Ciliary body
    • Choroid
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2
Q

Function of iris

A
  • Home of pupil
    • regulates light entering eye
    • Iris sphincter and dilator muscles
  • Maintain blood-aqueous barrier
    • important homeostasis and immune function
  • Plugs holes
    • corneal perforation
    • only in cases of emergency
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3
Q

Zones of the iris

A
  • Pupillary zone
  • Collarette
  • Ciliary zone
    • aka base of iris
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4
Q

Ciliary body function

A
  • Maintains blood-aqueous barrier
    • homeostasis
    • immune function
  • Produce aqueous humor
    • keeps eye at normal IOP
    • Ciliary body epithelium
    • dependent on carbonic anhydrase
  • Accomodation
    • ciliary procceses
      • zonules
      • lens
    • contraction of ciliary body muscle
      • relaxes zonules and allows near vision
      • increases drainage of aqueous via trabecular meshwork
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5
Q

Functions of choroid

A
  • Maintain blood-aqueous barrier
    • important homeostasis and immune function
  • support the retina
    • provide nutrients/oxygen to retina
    • remove wastes from retina
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6
Q

Choroid

location

A

Between Sclera and retinal epithelium

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7
Q

Blood-ocular barrier

A
  • Composed of two barriers
    • Blood-aqueous barrier
    • Blood-retinal barrier
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8
Q

Diseases of uveal tract

Congenital

A
  • Heterochromia
  • Hypopigmentation
  • Iris hypoplasia
  • Aniridia
  • Correctopia
  • PPMs
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9
Q

Diseases of uveal tract

Acquired

A
  • Iris atrophy
  • Inflammation
    • uveitis
  • Neoplasia
    • primary
    • secondary
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10
Q

Heterochromia

A
  • variation in iris coloration
  • different color between two eyes
  • different coloration within same iris
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11
Q

Uveal cysts

A
  • Congenital or acquired
    • can be secondary to inflammation
  • Produced by
    • ciliary body epithelium
    • epithelium of posterior iris
  • If large can be popped with a laser
  • Free floating, transilluminates, is round
    • melanocytomas are attached to iris, irregular
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12
Q

Persistent pupillary membranes

(PPM)

A
  • Remnants of tunica vasculosa
  • originate from collarette
    • can extend in different directions
      • iris to iris
      • iris to lens
        • can cause secondary cataracts
  • Typically don’t treat unless severe impairment of vision
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13
Q

Iris hypoplasia

A
  • Hypoplasia
    • incomplete development of iris
  • Aniridia
    • complete lack of iris tissue
      • rare
  • Consequences
    • photophobia
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14
Q

Congenital iris abnormalities

Iris coloboma

Dyscoria

Corectopia

A
  • Coloboma
    • lack of a portion of iris
    • typical vs atypical
  • Dyscoria
    • abnormal shape to pupil
  • Corectopia
    • abnormally positioned pupil
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15
Q

Iris atrophy

A
  • Lose tissue around pupil
    • scalloped pupil appearance
    • holes in iris stroma
  • consequence:
    • photophobia
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16
Q

Uveitis

Endophthalmitis

A
  • Uveitis: inflammation of uveal tract
    • Anterior uveitis: iris + ciliary body
    • Posterior uveitis: choroid
      • Chorioretinitis: inflammation of choroid + retina
  • Endophthalmitis: iris + ciliary body + choroid
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17
Q

Anterior uveitis

CS

A
  • Pain
  • tear overflow
  • enophthalmous
  • hyperemia
  • low IOP
  • miosis
  • corneal edema
  • aqueous flare
  • blephorospasm
  • conj hyperemia
  • hypopion: pus in anterior chamber
  • hyphema: blood in anterior chamber
  • Keratic percipitates
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18
Q

Hyphema

A
  • Positive observation for uveitis
  • Causes
    • Trauma
    • clotting
    • glaucoma
    • neoplasia
    • etc
  • TX
    • mydriatic use controversial
    • corticol steroids
    • NSAIDS
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19
Q

Keratic precipitates

A
  • Clinical sign of uveitis
    • corneal precipitates of inflammatory cells
      • things stick to the back of the cornea
20
Q

Rubiosis iridis

A
  • Swollen and redness of iris
  • clinical sign of uveitis
21
Q

Posterior synechiae

A
  • adhesions of iris posteriorly to lens
    • can also be anterior adhesions
  • clinical sign of uveitis
  • result of chronic inflammation
22
Q

Iris bombe

A
  • adhesion of pupil to anterior lens capsule
    • aqueous flows through anterior chamber
  • CS of uveitis
23
Q

Cataracts

A
  • can induce uveitis
  • can be induced by uveitis
24
Q

Subretinal exudate

A
  • clinical sign of posterior uveitis/chorioretinitis
25
lipidemic aqueous
* unique manifestation of uveitis * hyperlipidemia
26
Immune-mediated uveitis
* Lens-induced (LIU) * common in dogs b/c high freq cataracts * Uveodermatologic syndrome (UDS) * Golden Retriever / pigmentary uveitits * Equine Recurrent Uveitis (ERU) * Paraneoplastic syndrome * Idiopathic
27
Uveodermatologic syndrome
* predispositons * arctic breeds * young dogs * bilateral * acute/ chronic * CS * nose/skin lesions * depigmentation * Iridal depigmentation * Retinal degeneration/detachment * secondary glaucoma * cataracts * chronic progressive dz * blindness
28
Equine recurrent uveitis (ERU)
* AKA * moon blindness * periodic ophthalmia * iridocyclitis * Group of diseases with common clin pattern * most common cause of vision loss in horses * most common cause cataractsin horses * 'butterfly scars' * lepto may be trigger
29
Classic Equine recurrent uveitis
* Repeated bouts of severe inflammation * variable intervals between quiescence between bouts
30
Insidious cases ERU
* No overt episodes * slow deterioiration of the eye * low grade uveitis * appalossas or warmbloods * light base coat color more at risk for ERU * blanket rump less affected
31
Lens induced uveitis
* Form of immune-mediated uveitis * dogs react more intensely than cats * normal lens material less antigenic * cataract material more antigenic * antigenicity may increase with time * most frequent cause of secondary glaucoma in dog
32
Causes of uveitis
* Primary ocular dz * cataract * lens rupture * corneal ulcer * Idiopathic immune mediated uveitis * Trauma
33
Ocular manifestations of systemic dz
* infectious * metabolic * immune-mediated * neoplasia primary or secondary * toxemia * coagulopathies
34
Infectious causes uveitis dogs
* algae * parasitic * protozoan * rickettsial * bacterial * fungal * viral
35
Specific causes UVEITIS in dogs Examples in class
* Brucella canis anterior uveitis * Blastomycosis * ohio/mississippi basin * Infectious canine hepatitis (Canine adenovirus 1) * hepatitis blue eye
36
Infectious causes uveitis cats
* Bacterial * bartonella * Fungal * Viral * Parasitic * heartworms can cause anterior uveitis * Protozoan
37
Pigmentary Uveitis in Golden retrievers
* Newly recognized * Features * acute, chronic and recurrent panuveitis * pigment exfoliation * anterior uveal cysts * chronicity * secondary galucoma * secondary cataracts * angle collapse + cysts * contribute to glaucoma
38
Diagnosis of uveitis
* HX * vaccination * travel * indoor/outdoor * acute/chronic * previous meds * PE * Ophthalmic exam * Minimum database * CBC, serum chem, UA * Thoracic/abdominal rads * Area of country: Urine blasto antigen
39
Treating uveitis
* Goals * prevent complications: maintain sight * eliminate intraocular inflammation * stabilize and restore blood-aqueous barrier * TX * treat underlying cause * symptomatic therapy * Antiinflammatories * Anterior uveitis * topical * subconjunctival/subtenons * systemic * Posterior uveitis * systemic tx
40
NSAIDS
* Systemic * carprofen * Meloxicam * Flunixin meglumine * Topical * Diclofenac * Bromfenac * Flubiprofen * Indomethacin
41
Mydriatic therapy for uveitis Topical steroids
* Mydriatics function * Prevents synechia * paralyzes ciliary body muscle * help stabilize cell junction * decreases protein leakage * Mydriatic products * atropine 1% * tropicaminde 1% * scopolamine 0.25% + phenylephrine 10% * Topical steroids * dexamethasone 0.1% * prednisolone 1.0%
42
Immunosuppressant TX for uveitis
* Immunosuppressants * oral corticosteroids * azathioprine * cyclosporine
43
Sequelae of uveitis
* Persistent corneal edema * posterior synechia and iris bombe * secondary glaucoma * cataract * lens lux * phthisi bulbi * pain * posterior uveitis * retinal detachment * retinal degeneration * Loss of vision
44
Anterior uveal tumors dogs
* Types * Melanomas most common * from iris and ciliary body * benign and malignant types * Adenomas/adenocarcinomas * Lymphoma most common secondary tumor * CS * overt mass: pigmented/non-pigmented * chronic uveitis * spontaneous hyphema * progressive glaucoma * TX * laser therapy
45
Anterior uveal tumors in cats
* Types * diffuse iris melanomas * dark mass in iris * TX: enucleation ASAP * lymphomas * pink mass in iris * CS * iris color change * hyphema * visible mass * glaucoma

Ophtho (sophomore) (11 decks)

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