Diagnostic Approach to Retinal Vasculitis

Initial Clinical Examination

The American Academy of Ophthalmology recommends visual acuity testing with best correction 1
The American Academy of Ophthalmology suggests relative afferent pupillary defect assessment to evaluate for ischemia and neovascularization risk 1, 2
Intraocular pressure measurement is recommended by the American Academy of Ophthalmology 1, 2
Slit-lamp biomicroscopy examining carefully for anterior segment inflammation is suggested by the American Academy of Ophthalmology 2

Fluorescein angiography is the confirmatory test for retinal vasculitis, demonstrating vascular leakage, capillary nonperfusion, and distinguishing active inflammation from collateral vessels, according to the American Academy of Ophthalmology 2, 3
Optical coherence tomography is used to detect and quantify macular edema, assess vitreoretinal interface changes, and identify subretinal fluid, as recommended by the American Academy of Ophthalmology 2, 3, 4
Fundus photography is used for documentation of vascular sheathing, hemorrhages, and disease progression, according to the American Academy of Ophthalmology 2, 3

Inflammatory markers such as ESR and CRP are particularly useful if giant cell arteritis is suspected, as suggested by the American College of Rheumatology 5

OCT thickness measurements don't always correlate with visual acuity, requiring clinical judgment beyond imaging metrics, according to the American Academy of Ophthalmology 2, 3
FA must be performed with informed consent acknowledging rare but serious risks including death, with emergency protocols in place, as recommended by the American Academy of Ophthalmology 3, 4