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Visual outcomes and prognostic factors in ischaemic retinal vasculitis
Aaron Yap1,2, Helen Kearns2, Joanne L Sims2
1Department of Ophthalmology, The University of Auckland, Auckland, New Zealand.
The British Journal of Ophthalmology
|August 1, 2024
Summary
Ischaemic retinal vasculitis (IRV) can lead to moderate-to-severe vision loss in 21% of patients over five years. Factors like retinitis and cystoid macular edema predict poor outcomes, while ultra-widefield angiography aids risk assessment.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
- Medical Research
Background:
- Ischaemic retinal vasculitis (IRV) is a serious condition affecting the retinal vasculature.
- Understanding visual outcomes and predictive factors is crucial for patient management.
Purpose of the Study:
- To describe visual outcomes in patients with IRV.
- To identify clinical factors predicting poor visual prognosis or infectious causes of IRV.
Main Methods:
- A retrospective cohort study was conducted.
- Data from consecutive IRV presentations to Auckland District Health Board (2009-2022) were analyzed.
Main Results:
- Infectious aetiology was identified in 52.1% of cases.
- Moderate-to-severe vision loss occurred in 21% of patients over a median follow-up of 4.8 years.
- Retinitis and cystoid macular oedema (CME) were significantly associated with vision loss. Retinal haemorrhage, retinal vein occlusion, and quadrants of ischaemia predicted vitreous haemorrhage.
Conclusions:
- A significant proportion of IRV patients experience vision loss.
- Retinitis is predictive of infectious aetiology, while cotton wool spots suggest non-infectious causes.
- Ultra-widefield fluorescein angiography is a valuable tool for assessing neovascular complication risk and guiding treatment.
