Uveitis - Posterior Uveitis

Front 1

ARN
6 major sign
2 possible signs

Back 1

1. One or more foci or retinal necrosis with discrete borders in the peripheral retina
2. Rapid progression in the absense of therapy
3. Circumferential spread of disease
4. Occlusive arteriolar vasculopathy
5. Vitritis
6. AC reaction
scleritis and pain possible

Front 2

Presenting symptoms of ARN

Back 2

pain
severe vitritis

Front 3

3 Findings of ARN on DFE

Back 3

Vitritis
Discrete areas of retinal whitening
Vasculitis

Front 4

Final complication of ARN

Back 4

RD b/c retina is thin and develops holes
Optic neuropathy

Front 5

ARN age less than 20 think what?

Back 5

Think reactivated congenital HSV 2

Front 6

T/F ARN is more common in immunocompitant pts

Back 6

True

Front 7

Treatment for ARN

Back 7

Tap and Inject with foscarnet

Front 8

What is the difference between HSV 1 and 2 with ARN

Back 8

HSV 1 is much more severe can have encephalitis, assume systemic disease, need IV acyclovir 1500mg/day in 3 divided doses

Front 9

Acyclovir toxicity

Back 9

renal

Front 10

Treatment time for ARN

Back 10

6 weeks antiviral systemically

Front 11

Prognosis of ARN without treatment

Back 11

1/3 retain 20/200 or better

Front 12

Prognosis with ARN

Back 12

1/2 are better than 20/40, 90% 20/200 or better

Front 13

What is the time course of other eye involvement for ARN

Back 13

up to 35 yrs later, need long term antivirals

Front 14

Presentation of PORN

Back 14

Posterior pole can be affected on presentation
Little Vitritis - b/c immunocomp
Vasculitis may have area of clearing around vessels

Front 15

T/F PORN is more common in immunocompitant pts

Back 15

False

Front 16

RX for PORN

Back 16

Intravit foscarnet
and systemic antivirals, acyclovir

Front 17

CMV retinitis happens in who

Back 17

immunocompromised pts

Front 18

CMV retinal 4 findings

Back 18

Lacy white retinal necrosis
Pizza fundus
Sectoral necrosis
Frosted angitits

Front 19

CMV treatment

Back 19

oral valgancyclivir, 3 weeks of induction

Front 20

risk of valgancyclovir

Back 20

marrow suppression

Front 21

problems with valgancyclovir rx

Back 21

resistance at 6 months

Front 22

When can stop valgancyclivir in CMV retinitis

Back 22

6 months after immune reconsitution

Front 23

2nd line agent for CMV retinitis

Back 23

systemic foscarnet

Front 24

cidofovir eye problems

Back 24

hypototony and uveitis

Front 25

Immune reconstitution uveitis
3 signs
Who gets it
What is the cause
Treatment

Back 25

CME
AC cell
Vit cell
Pt who had CMV retinitis get it
Cause: autoimmune
Treatment: steroids

Front 26

What is required in PPV in CMV RD

Back 26

silicone oil b/c retina is very thin

Front 27

Ocular toxoplasmosis 2 sx

Back 27

Floaters
Scotomas

Front 28

Ocular toxoplasmosis
3 signs

Back 28

Dense vitritis
Old scars with loss of choriocapilaris
New retinal lesions

Front 29

What is the chance of congenital toxo if mom converts during pregnancy

Back 29

40% chance

Front 30

Incidence of congenital toxo in the US

Back 30

0.1% in the US

Front 31

What are sources of Toxo

Back 31

Undercooked Meat
Water
Cats

Front 32

3 forms of toxo

Back 32

oocyts, tachyzoites, bradyzoits

Front 33

4 indications for treatment of ocular toxoplasmosis

Back 33

Foveal or optic nerve
AIDS
Transplant pts
Chronic recurrences 2-3x/year

Front 34

Treatment for Toxoplasmosis
Primary
Monitoring
2 alternatives

Back 34

triple sulfa
Sufadiazine
Trimetoprim
folinic acid
follow platelets
can also use Clindamycin or Zithromax or Septra

Front 35

Length of resolution of Toxoplasmosis

Back 35

Can take months/year for center or lesion to scar

Front 36

Toxocariasis is caused by what

Back 36

toxocara canis, 80% of puppies have this worm

Front 37

3 fundus findings in toxocariasis

Back 37

eosinophilic retinal reaction
subretinal granulomatous lesion with traction bands to optic nerve
dense vitritis

Front 38

Dx of Toxocariasis

Back 38

ELISA because there is a low pretest probability

Front 39

Treatment of Toxocariasis

Back 39

antiinflammatories, antihelminthic agents case worm death and more inflammation

Front 40

DUSN is

Back 40

Diffuse unilateral neuroretinitis

Front 41

Late finding after DUSN

Back 41

RP like picture

Front 42

Rx for DUSN

Back 42

laser the worm

Front 43

3 Lupus findings

Back 43

cotton wool spots
vasculopathy
arteriolitis

Front 44

Polyarteritis nodosa
2 findings
How to diagnose

Back 44

elevated ESR
vasculitis

tissue dx

Front 45

Wegeners
2 Findings
1 Diagnostic test

Back 45

scleritis and nephritis
C-ANCA

Front 46

Ocular candida found in who

Back 46

Indwelling lines
immunocopromised

Front 47

Ocular candida findings

Back 47

Retinitis and Vit fluff balls

Front 48

Rx candida

Back 48

Voriconazole or Diflucan