Ophthalmology · Uveitis (Anterior, Posterior, Panuveitis)

In Behcet's disease associated uveitis, the pathognomonic fundus finding that distinguishes it from other forms of panuveitis is:

  • A Choroidal granulomas with subretinal fluid on OCT
  • B Dalen-Fuchs nodules between the RPE and Bruch's membrane
  • C Occlusive retinal vasculitis affecting arteries and veins simultaneously, with dense vitritis and retinal infiltrates causing rapid visual loss
  • D Periphlebitis with 'candle-wax dripping' appearance on FFA
Correct answer: C. Occlusive retinal vasculitis affecting arteries and veins simultaneously, with dense vitritis and retinal infiltrates causing rapid visual loss

Explanation

Behcet's disease causes an obliterative/occlusive retinal vasculitis that uniquely affects both arteries and veins simultaneously, unlike most other retinal vasculitides. This bilateral occlusive vasculitis leads to large areas of retinal infarction, with dense vitritis, snowflake vitreous opacities, and rapidly progressive visual loss. FA shows arterial and venous occlusions, widespread capillary non-perfusion, and leakage. Untreated, bilateral blindness occurs in 25% within 5 years. Treatment involves cyclosporine, azathioprine, and anti-TNF agents (infliximab, adalimumab — approved by FDA for non-infectious uveitis). Dalen-Fuchs nodules are seen in VKH and sympathetic ophthalmia. Candle-wax dripping periphlebitis is characteristic of sarcoidosis.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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