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II. Anterior Segment Disease > Uveitis (F) > Flashcards

Uveitis (F) Flashcards

1
Q

What are the three tunics of the eye?

A
  1. scleral
  2. uveal
  3. retinal
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2
Q

What are the three main aspects of uveitis to consider?

A
  1. anatomical location
  2. timing of inflammation
  3. etiology
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3
Q

What are the three parts of the uvea (and the function of each)?

A
  1. iris (light aperture)
  2. ciliary body (accommodation and aqueous production)
  3. choroid (nourishment to outer retina)
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4
Q

What are the types of anterior uveitis?

A
  1. iritis

2. iridocyclitis

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5
Q

What are the types of intermediate uveitis?

A

pars planitis (includes pars plana, peripheral retina and vitreous)

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6
Q

What are the types of posterior uveitis?

A
  1. choroiditis
  2. retinitis
  3. neuroretinitis
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7
Q

What is inflammation in the entire uveal tract without predominant site called?

A

panuveitis

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8
Q

What are the cutoffs for the time periods involved in duration of uveitis?

A
  1. limited (3 months)

2. persistent (>3 months)

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9
Q

What course of uveitis is sudden in onset and has limited duration?

A

acute

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10
Q

What course of uveitis comes back in

A

chronic

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11
Q

What course of uveitis comes back >3M after Tx D/C?

A

recurrent

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12
Q

What course of uveitis is inactive disease >3M after Tx D/C?

A

remission

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13
Q

What are the etiologies of inflammation of uveitis?

A
  1. autoimmune
  2. infectious
  3. trauma
  4. inherited
  5. idiopathic
  6. masquerading
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14
Q

How many cells per field are in each of the grades 0-4 in the anterior chamber?

A
  1. no cells
    0.5+. 0-5 cells
    1+. 6-15 cells
    2+. 16-25 cells
    3+. 26-50 cells
    4+. >50 cells
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15
Q

What must occur in order for tapering off steroids to begin?

A

2 step improvement on AC cells scale and/or flare scale

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16
Q

What is the milky appearance of AC due to accumulation of proteins called? 1. What is it due to? 2

A
  1. flare

2. break down of blood-aqueous barrier

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17
Q

What are the descriptions for flare in the AC from grade 0-4?

A
  1. complete absence
  2. faint (barely detectable)
  3. moderate (iris and lens details clear)
  4. marked (iris and lens details hazy)
  5. intense (coagulation, fibrin in AC)
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18
Q

What are inflammatory cells the deposit on the corneal endothelium called? 1. How many days after inflammation starts does this occur? 2.

A
  1. keratic precipitates (KPs)

2. 2-3 days after

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19
Q

What are the three types of keratic precipitates (which are granulomatous?)?

A
  1. small, fine, discrete, white (non-granulomatous) 1mm

3. stellate (non-granulomatous)

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20
Q

What are mutton fat KPs composed of?

A
  1. epithelioid cells

2. mononuclear macrophages

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21
Q

When are stellate KPs seen?

A
  1. Fuchs heterochromia

2. Herpes

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22
Q

Where do KPs usually precipitate on the cornea? 1. What is the exception? 2

A
  1. inferior half

2. stellate KPs

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23
Q

What are iris adhesions due to protein and fibrin in AC called? 1. What is used to break the adhesion? 2

A
  1. synechia

2. cycloplegia

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24
Q

Are posterior synechia or peripheral anterior synechia more common?

25
Q

What is it called when the iris pigment is imprinted on the lens following a synechia? 1. What is it associated with if sectorial iris atrophy is also seen? 2

A
  1. Vossius ring

2. HZV

26
Q

Which hypoyon is more fluid and not as flat?

A

hypoyon in Behcets disease

27
Q

What are hemispheres of inflammatory cells that collect on the iris called?

A

iris nodules

28
Q

What type of iris nodule is at the pupillary border (and is it granulomatous/ non or both)? 1. What type is on the anterior iris surface (granulomatous?)? 2. What type is in the angle (granulomatous?)? 3

A
  1. Koeppe (non-gran and granulomatous)
  2. Busacca (granulomatous)
  3. Berlin (granulomatous)
29
Q

Does acute anterior uveitis have inc or dec IOP? 1. Why? 2

A
  1. decreased IOP

2. dec aqueous secretion

30
Q

Does chronic anterior uveitis have inc or dec IOP? 1. Why? 2

A
  1. inc IOP

2. build up of cell in or inflammation of trabecular meshwork

31
Q

What are the types of lens opacifications associated with anterior uveitis?

A
  1. epicapsular stars and/or pigment debris

2. posterior subcapsular cataract

32
Q

What can cause posterior subcapsular cataracts that is involved in uveitis?

A
  1. chronic iritis

2. steroid treatment

33
Q

What are the percent of anterior uveitis patients that have each of these signs:

  1. posterior synechiae
  2. cataract
  3. glaucoma due to PAS
  4. band keratopathy
A
  1. 30%
  2. 20%
  3. 15%
  4. 10%
34
Q

What are the two essential corticosteroids to know for the treatment of uveitis?

A
  1. Pred forte (Prednisone acetate)

2. Letomax (Loteprednol etabonate)

35
Q

What is the drug that puts the iris and ciliary body at rest and is used to break/prevent synechia?

A

cycloplegics

36
Q

What are the aspects that are assessed to describe the type of uveitis?

A
  1. location
  2. laterality
  3. characteristic (granulomatous or non)
  4. course and duration
  5. patient demographics
37
Q

Are HLA-B27 positive patients seropositive or seronegative? 1. What percentage of patients with anterior uveitis have are HLA-B27 positive? 2. Is treatment more or less aggressive? 3

A
  1. seronegative
  2. 50-60%
  3. more aggressive
38
Q

What are the traits associated with anterior uveitis that is linked to HLA-B27 positive patients?

A
  1. fibinoid (stiff) hypopyon
  2. recurrent
  3. unilateral
  4. non-granulomatous
39
Q

What percent of all uveitis cases are idiopathic? 1. Of anterior cases? 2

A
  1. 30%

2. 50%

40
Q

What are the differential diagnoses for Fuch’s Heterochromic Iridocyclitis?

A
  1. congenital hypochromia
  2. congenital Horners
  3. iris nevus or melanoma
  4. unilateral topical prostaglandin analogue for glaucoma
41
Q

What are the diseases associated with iridocyclitis and intermediate uveitis?

A
  1. intermediate uveitis (idiopathic)
  2. Fuch’s Heterochromic Iridocyclitis
  3. Juvenile Idiopathic Arthritis
42
Q

What are the diseases associated with iridocyclitis with posterior inflammation?

A
  1. Sarcoidosis
  2. Ischemic ocular inflammation
  3. syphilis
43
Q

What diseases cause ischemic ocular inflammation? 1. What are the ocular signs of this? 2

A
  1. giant cell arteritis and diabetic retinopathy

2. cells and flare, peripheral synechia, and sluggish pupils

44
Q

What can the test ESR be used to diagnose?

A

vascular occlusive (AS and RA)

45
Q

What can the test CBC be used to diagnose?

A
  1. bacterial vs viral

2. leukemia

46
Q

What can the test ANA be used to diagnose?

A

1, JIA

  1. Sjogrens
  2. Lupus
47
Q

What can the test RF be used to diagnose?

A
  1. RA
  2. Sjogrens
  3. Lupus
48
Q

What can the test Anti-CCP be used to diagnose?

49
Q

What can the test CRP be used to diagnose?

A

presence of inflammation

50
Q

What can the test VDRL be used to diagnose?

A

syphilis (current)

51
Q

What can the test RPR be used to diagnose?

A

syphilis (current)

52
Q

What can the test FTA be used to diagnose?

A

syphilis (past)

53
Q

What can the test ACE be used to diagnose?

A

sarcoid, any other granulomatous diseases

54
Q

What can the test PPD be used to diagnose?

55
Q

What are the malignancy masqueraders? 1. When are they included in DDx? 2

A
  1. Lymphoma, leukemia, retinoblastoma

2. chronic uveitis that is not responsive to steroids

56
Q

What diseases result in the reduction in corneal sensitivity?

A
  1. herpes
  2. leprosy
  3. Reis-Bucklers Dystrophy
  4. Diabetes
  5. Tight CL (hypoxia)
57
Q

What are the five things to perform for effective iritis management?

A
  1. check IOPs
  2. ask about previous ocular surgeries
  3. systemic work-up (if bilateral, chronic, or recurrent)
  4. treat aggressively to restore blood-aqueous barrier
  5. dilate and examine posterior pole
58
Q

What are the six initial tests to run for a systemic work-up of iritis?

A
  1. CBC with diff (check lymph nodes too)
  2. SED rate (ESR)
  3. HLA-B27 antibody
  4. ANA
  5. FTA-ABS
  6. ACE

II. Anterior Segment Disease (11 decks)

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