Retinal Vasculitis
White cuff around retinal vessels that looks like frosting ("vascular sheathing") Made up of perivascular lymphocytes Caused by vascular inflammation ("vasculitis") associated with sarcoidosis, Behçet disease, and other autoimmune conditions
Retinal vessel (usually vein) segmentally surrounded by thin white cuff that varies in thickness along vessel
Silver-wiring in chronic hypertension, where arterial wall is so thickened that red blood column is obliterated, BUT...in vasculitis you should see blood column unless vessel is occludedAttenuation of retinal nerve fiber layer from optic neuropathy Old retinal artery occlusion
Interpret this finding as sign of retinal vascular inflammation and think of diseases that do this Refer to ophthalmologist non-urgently unless symptoms are new and marked
Vasculitis may be restricted to eye, but more commonly it affects vessels in other tissues, so... Patient needs systemic work-up In retina, vessels can become occluded and cause blindness unless treatment undertaken
