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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
Q

lipidemic aqueous

A
  • unique manifestation of uveitis
  • hyperlipidemia
26
Q

Immune-mediated uveitis

A
  • 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
Q

Uveodermatologic syndrome

A
  • 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
Q

Equine recurrent uveitis (ERU)

A
  • 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
Q

Classic Equine recurrent uveitis

A
  • Repeated bouts of severe inflammation
  • variable intervals between quiescence between bouts
30
Q

Insidious cases ERU

A
  • 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
Q

Lens induced uveitis

A
  • 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
Q

Causes of uveitis

A
  • Primary ocular dz
    • cataract
    • lens rupture
    • corneal ulcer
  • Idiopathic immune mediated uveitis
  • Trauma
33
Q

Ocular manifestations of systemic dz

A
  • infectious
  • metabolic
  • immune-mediated
  • neoplasia primary or secondary
  • toxemia
  • coagulopathies
34
Q

Infectious causes uveitis

dogs

A
  • algae
  • parasitic
  • protozoan
  • rickettsial
  • bacterial
  • fungal
  • viral
35
Q

Specific causes UVEITIS in dogs

Examples in class

A
  • Brucella canis anterior uveitis
  • Blastomycosis
    • ohio/mississippi basin
  • Infectious canine hepatitis (Canine adenovirus 1)
    • hepatitis blue eye
36
Q

Infectious causes uveitis

cats

A
  • Bacterial
    • bartonella
  • Fungal
  • Viral
  • Parasitic
    • heartworms can cause anterior uveitis
  • Protozoan
37
Q

Pigmentary Uveitis in Golden retrievers

A
  • 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
Q

Diagnosis of uveitis

A
  • 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
Q

Treating uveitis

A
  • 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
Q

NSAIDS

A
  • Systemic
    • carprofen
    • Meloxicam
    • Flunixin meglumine
  • Topical
    • Diclofenac
    • Bromfenac
    • Flubiprofen
    • Indomethacin
41
Q

Mydriatic therapy for uveitis

Topical steroids

A
  • 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
Q

Immunosuppressant TX for uveitis

A
  • Immunosuppressants
    • oral corticosteroids
    • azathioprine
    • cyclosporine
43
Q

Sequelae of uveitis

A
  • 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
Q

Anterior uveal tumors

dogs

A
  • 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
Q

Anterior uveal tumors in cats

A
  • 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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