Ocular Vascular Involvement in the Rheumatic Diseases
Retinal vascular disease often occurs in conjunction with systemic inflammatory disease, particularly Behcets disease and Systemic Lupus Erythematosus. In contrast to other manifestations of vasculitides, those affecting the posterior segment of the eye are accessible to direct visualisation by ophthalmoscopy, enabling a number of the features to be distinguished on clinical examination. Retinal vascular disease frequently carries a poor visual prognosis, and macular ischaemia leads to irreversible visual loss. Early disease identification and institution of appropriate management is therefore valuable in reducing the morbidity of these conditions. The vascular manifestations of different rheumatological diseases will be discussed, together with current and emerging therapies, including corticosteroids, second-line immunosuppression and biological agents, as well as the potential role for interferon alpha in the management of Behcets disease.
Keywords: Retinal vasculitis, Behcet's disease, systemic lupus erythematosus, interferon alpha, autoimmune, Rheumatic Diseases, vasculitides,, ophthalmoscopy,, macular ischaemia leads, fluorescein angiography, sheathing, phlebitis, arteritis, sarcoidosis, polyarteritis nodosa, Wegener's granulomatosis, Churg-Strauss syndrome, cryoglobulinaemia, antiphospholipid syndrome, ischaemic optic neuropathies, choroidal stroma, choriocapillaris, Ocular Ischaemic Syndrome, arteriovenous shunts, retinal neovascularisation, bypass graft surgery, macular ischaemia, neovascular glaucoma, vitreous haemorrhage, genital ulcers, maculopathy, Retinitis, Sjögren syndrome, antiphospholipid anti-bodies, Lupus optic neuropathy, optic neuritis, polychondritis, Giant cell arteritis (GCA), Amaurosis fugax, retinopathy, Scleroderma, Azathioprine, Methotrexate, Ciclosporin, cyclophosphamide, Infliximab, Anti-CD20 therapy, Daclizumab, triamcinolone acetate, photocoagulation, neovascularisation, anti-VEGF
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