4.4 Review

Occlusive retinal vasculitis: novel insights into causes, pathogenesis and treatment

Journal

CURRENT OPINION IN OPHTHALMOLOGY
Volume 33, Issue 3, Pages 147-156

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICU.0000000000000843

Keywords

brolucizumab; retinal vasculitis; TREX1; uveitis

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This review discusses the causes and treatment options for occlusive retinal vasculitis (ORV), including genetic mutations associated with ORV, ORV caused by intraocular therapeutics, and ORV linked to Behcet's disease. Identifying the underlying etiology is crucial for guiding treatment, which involves treating underlying infections or autoimmune conditions, stopping any causative agents, and managing neovascular complications.
Purpose of review Occlusive retinal vasculitis (ORV) has a large differential diagnosis and varied therapeutic approaches. This review highlights existing and novel causes and treatment options for ORV. Recent findings Mutations in CAPN5, TREX1, and TNFAIP3 have been associated with dominantly inherited forms of ORV. Various intraocular therapeutics have been shown to occasionally cause ORV; the most recent medications associated with ORV are vancomycin and brolucizumab. In cases of ORV linked to Behcet's disease, clinical trials support the use of tumor necrosis factor alpha inhibitors. Identification of the underlying etiology of ORV is critical to help guide treatment. Treatment in ORV involves both treatment any underlying infection or autoimmune condition, cessation of the any offending causative agent and local treatment of neovascular complications.

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