Retinitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Physical signs associated with retinitis will vary according to the underlying condition responsible for the disease. Genetic defects will result in a genetic disorder known as Retinitis pigmentosa. The presentation of this disorder is primarily visible in the degradation as well as degeneration of cone and rod cells.^[1] Infectious agents will present physical manifestations according to the underlying cause of infection. These clinical manifestations will range for yellowish infiltrates to inflammation and lesions localized to specific areas of the eye.^[2]

The physical signs associated with retinitis are specific to the underlying cause of the disease. There are two distinct causes of retinitis, genetic disorders and infectious agents. Genetic disorders are commonly linked to physical degeneration. Degradation of cones and rod cells will serve as physical indicators of disease progression. Infectious agents are classified as parasitic, fungal or bacterial. Fungal agents are associated with the presence of circumscribed lesions, with potentially visible hyphae or yellowish infiltrates. Bacterial infections may be associated with retinal hemorrhaging as well as lesions in previously scarred areas.

Physical evidence of a cytomegalovirus presence in one of both eyes will generally clinical present in the form of lesions, adjacent retinal vessels.
These lesions may impinge upon the fovea and the optic nerve. Furthermore they are usually discovered in close proximity to both.
Further extending lesions may be present in close proximity to the vortex veins as well as the ora serrata.^[2]

Caseating granulomas
Multiple choroidal tubercles- small grayish nodules located on the posterior pole of the eye
Yellow necrotizing granulomas^[2]

Yellow subretinal infiltrates
Retinal infiltrates
Fungal hyphae are located throughout the eye - suggestive of pulmonary involvement^[2]

↑ ^1.0 ^1.1 Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.genome.gov/13514348
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 ^2.5 ^2.6 ^2.7 Infectious Retinitis: A Review. YACHNA AHUJA, MD · STEVEN M. COUCH, MD · RAYMUND R. RAZONABLE, MD · SOPHIE J. BAKRI, MD. http://www.retinalphysician.com/articleviewer.aspx?articleID=102293. Accessed April 13, 2016.