Differential diagnosis of retinal vasculitis
May be inflammatory (vasculitis) or noninflammatory (vasculopathy), with atherosclerosis being the most common cause of abnormal retinal vessels. Inflammatory causes are generally grouped into three categories:
- 1. Systemic diseases: Behçet’s disease, sarcoidosis, and multiple sclerosis are the most common. SLE can be associated with retinal vasculitis, but it is more commonly associated with choroiditis. Retinal vasculitis is less frequently associated with other rheumatic diseases including ANCA-associated vasculitis, large- and medium-vessel vasculitis (e.g., GCA), Susac syndrome, and APS. Primary CNS lymphoma, acute leukemia, paraproteinemias, and cancer-associated retinopathy are other rare causes.
- 2. Infectious: toxoplasmosis, TB, Lyme disease, syphilis, cat scratch disease, herpes simplex, and varicella zoster are the most common. Less frequent associations include CMV, human immunodeficiency virus (HIV), Whipple’s disease, HTLV-1, brucellosis, and leptospirosis.
- 3. Primary ocular syndromes: idiopathic retinal vasculitis, pars planitis, birdshot retinochoroidopathy, frosted branch angiitis, Eales’ disease, and IRVAN syndrome.