Uveitis Flashcards
What are the clinical signs of uveitis?
corneal edema, conjunctival hyperemia, scleral blood vessel congestion, aqueous flare, hypopyon, hyphema, miosis, vitreous cellularity, chorioretinitis and hypotony
What can chronic uveitis lead to?
corneal edema, corneal neovascularization, hypopyon, posterior synechia, keratic precipitates, hyphema, cataract formation, vitreous degeneration, retinal degeneration, retinal detachment and phthisis bulbi
Outline treatment for uveitis
Specific therapy is directed at the underlying cause of the uveitis, whereas the goal of nonspecific therapy is to decrease intraocular inflammation and prevent ocular adhesions and scarring. Nonspecific therapy is usually a combination of topical anti‐inflammatory medications [e.g. nonsteroidal anti‐inflammatory drugs (NSAIDs)] and mydriatics (e.g. atropine or tropicamide), with or without the use of systemic anti‐inflammatory medications.
How do you fully evaluate uveitis?
complete ophthalmic and physical examination, complete blood count, serum chemistry panel, urinalysis, imaging studies of the thorax and abdomen, ocular ultrasound, appropriate serology, microbiology if indicated, histopathology of ocular tissue when available, and in some cases aqueous and/or vitreous cytology
What are the main causes of uveitis in dogs?
infectious diseases (e.g. blastomycosis, Toxoplasma gondii, Leishmania donovani, Borrelia burgdorferi, Dirofilaria immitis, Ehrlichia canis, Ricketsia ricketsii and infectious canine hepatitis), immune‐mediated syndromes (e.g. uveodermatologic syndrome, Golden Retriever/cyst‐associated uveitis, German Shepherd panuveitis, vaccine associated etc.), and neoplasia However most are diagnosed as idiopathic
How may signalment/ other findings help to point the cause of uveitis?
Infectious more common in younger animals
Neoplastic in older
bilateral uveitis makes idiopathic disease less likely
Systemic signs of disease make idiopathic disease less likely
What are the most common neoplasms associated with uveitis?
By far most common is lymphoma
Uveal melanoma, haemangiosarc, all possibilities
Compare cat and dog causes of uveitis
Infectious more common in cats -83–90% of samples were positive for infectious organisms (including feline immunodeficiency virus, feline leukemia virus, feline corona virus, Bartonella felis and Toxoplasma gondii)
How can you assess high blood pressure in the cat
Pictures from here https://onlinelibrary-wiley-com.liverpool.idm.oclc.org/doi/full/10.1046/j.1463-5224.2001.00190.x
What is the uvea?
Choroid, iris, and ciliary body
Anterior uveitis - iris and ciliary body
Posterior - choroid
As the choroid is so close to the retina, posterior uveitis is often call chorioretinitis
What are the treatment implications of anterior and posterior uveitis?
Posterior segment disease must be treated via the systemic route while anterior segment inflammation may be treated with topical application of drugs that penetrate the cornea.
How does the feline iris change appearance with uveitis?
With uveitis, iridal swelling is evident as a ‘muddy’ or flattened iris surface, sometimes in association with nodular swellings.
may see rubeosis iridis
When do episcleral vessels become engorged?
uveitis, other intraocular diseases and deep corneal disease
What are the main infectious causes of feline uveitis?
FIP FIV FeLV FHV
Bartonella, Borellia, Erlichia, Mycobacterium
Fungus
Toxoplasma
Compare the main neoplastic causes of uveitis
most common primary intraocular neoplasm is melanoma, this typically causes little or no uveitis. By sharp contrast, the most com-mon metastatic ocular neoplasm – lymphoma –tends to be associated with marked breakdown of the BAB with hypopyon formation, fibrin exudation into the anterior chamber, and hyphaema
