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- Neuroretinitis is an acute inflammatory condition of the retina defined by optic disc edema and stellate maculopathy.
- A characteristic pattern of macular exudates surrounds the fovea.
- Vitreous cells are common.
- Although many cases remain idiopathic, a broad list of infectious and autoimmune conditions has been associated.
- Various forms of neuroretinitis include the following:
- Leber idiopathic stellate neuroretinitis
- Diffuse unilateral subacute neuroretinitis
- Idiopathic retinitis
- Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN)
- Recurrent neuroretinitis
- No gender predilection
- Ages have been reported from 8 to 55 years, with an average of 28 years.
- Epidemiologic data are limited for neuroretinitis.
Etiology and Pathophysiology
- The underlying pathophysiology involves increased permeability of disc vasculature, but the exact etiology is not fully defined.
- Optic disc edema is thought to be from the leakage of vessels within the optic nerve as demonstrated by fluorescein angiography (1).
- Juxtapapillary leakage may contribute to focal detachment and exudates.
- Exudates within the outer plexiform layer form the characteristic stellate pattern (2). These exudates get reabsorbed by macrophages.
- Idiopathic (up to 50% of cases)
- Various bacterial, viral, protozoal, and parasitic causes have been described or suspected (2).
- More commonly described are Bartonella henselae, Rickettsia typhi, Mycobacterium tuberculosis, Borrelia burgdorferi, Treponema pallidum, Leptospira spp., Toxoplasma gondii, HIV, herpes simplex virus, herpes zoster virus, Epstein-Barr virus, hepatitis B, hepatitis C, mumps, coxsackie B, Toxocara canis, Histoplasma capsulatum, Brucella spp.
- Autoimmune conditions include antiphospholipid syndrome and sarcoidosis.
No known genetic component
Varies by underlying etiology
Treat any identified underlying etiologies.
Commonly Associated Conditions
- Infectious and autoimmune disorders
- Variations include Leber idiopathic stellate neuroretinitis, diffuse unilateral subacute neuroretinitis (associated with nematode infection), idiopathic retinitis, vasculitis, IRVAN, and recurrent neuroretinitis.