What laboratory evaluation is indicated in the evaluation of retinal vasculitis?
Initial evaluation should include a CBC, comprehensive metabolic panel, UA, ESR, CRP, HIV screening, syphilis serology, chest radiograph, and TB screening (PPD or interferon-gamma release assay). Further evaluation is determined by the results of the history, physical examination, and initial screening studies and is guided by the diagnosis suspected.
Patients presenting with occlusive vasculopathy warrant additional discussion, given that noninflammatory etiologies such as atherosclerosis represent a substantial proportion of cases. Inflammatory rheumatic disease is a less common cause of branch or central retinal vein occlusions as well as retinal artery occlusions. As such, routine evaluations for inflammatory disease should be reserved for patients with extraocular signs and symptoms suggestive of a rheumatic condition. APS may be an exception, however, especially in patients presenting with ischemic injury in other sites (e.g., stroke), as the diagnosis may lead to a change in therapy (anticoagulation).
