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🎧 MSRA Podcast: Chorioretinitis – Causes, Clues & Complications
In this high-yield MSRA podcast, we break down Chorioretinitis—a potentially sight-threatening inflammation of the retina and choroid. Expect red flags, real case clues, and memory aids to supercharge your revision.
🧠 What You’ll Learn
✅ Definition
• Inflammation of the retina + choroid
• Can be infectious (e.g. toxoplasma, CMV, syphilis) or autoimmune (e.g. sarcoidosis, Behçet’s)
• May be congenital or acquired, with fluid leakage and inflammation
🔬 Causes & Risk Factors
🦠 Infectious:
• Toxoplasma gondii (most common)
• CMV, EBV, syphilis, TB, histoplasma
🧬 Non-infectious:
• Sarcoidosis, Behçet’s, VKH, malignancy
⚠️ Risk Factors:
• Immunosuppression (HIV, steroids)
• STIs (syphilis)
• Soil/water exposure (toxoplasma/fungi)
• Systemic inflammatory disease
🧠 Mnemonic: A-I-M – Autoimmune, Infectious, Malignancy
📋 Differentials
• Retinal detachment
• Macular degeneration
• Posterior uveitis
• PVD, vitreous haemorrhage
🧠 Mnemonic: DUMP VR – Detachment, Uveitis, Macula, PVD, Vasculitis, Retinoblastoma
📊 Epidemiology (UK)
• Toxoplasma = top cause of posterior uveitis (ages 10–35)
• CMV → advanced HIV
• Congenital CMV ~0.2–2%
• Autoimmune links more varied
👁️ Symptoms
• Blurred vision, floaters, scotomas
• Photophobia, pain, colour change
• Redness, sometimes asymptomatic in congenital cases
🩺 Exam Findings
• Active: yellow-white lesions
• Inactive: scars + pigment
• Vitreous haze, oedema, IOP changes
• Do fundoscopy, OCT, IOP check
🔎 Investigations
• OCT, fluorescein angiography
• Serology: toxoplasma, CMV, syphilis, HIV, TB
• CXR, MRI for systemic signs
• Eye fluid sampling in complex cases
💊 Management
1️⃣ Treat the cause
• Toxoplasma: pyrimethamine + sulfadiazine + folinic acid
• CMV: ganciclovir/valganciclovir
• Syphilis: IV benzylpenicillin
• ± corticosteroids (use cautiously)
2️⃣ Control inflammation
• Topical/systemic steroids
• Immunosuppressants (e.g. methotrexate, TNFi)
• Anti-VEGF for CNV
3️⃣ Supportive care
• Monitor with OCT, slit lamp
• Urgent referral for floaters/vision loss
📉 Prognosis
• Variable—depends on cause + location
• Macular lesions = ↑ risk of permanent loss
• Congenital toxo in UK = good outcomes
• Recurrence is common (toxo, autoimmune)
• Early diagnosis = better outcomes
⚠️ Complications
• Retinal scarring, macular oedema
• CNV, glaucoma, retinal detachment
• Optic nerve damage, vision loss
• Amblyopia in children
🧠 Mnemonic: MEG SCAR – Macular oedema, Endophthalmitis, Glaucoma, Scarring, CNV, Amblyopia, Retinal detachment
📚 Chorioretinitis MSRA Resources
📝 Notes: https://www.passthemsra.com/topic/cho... (https://www.passthemsra.com/topic/cho...)
🧠 Flashcards: https://www.passthemsra.com/topic/cho... (https://www.passthemsra.com/topic/cho...)
📖 Q&A: https://www.passthemsra.com/topic/cho... (https://www.passthemsra.com/topic/cho...)
🎯 Rapid Quiz: https://www.passthemsra.com/topic/cho... (https://www.passthemsra.com/topic/cho...)
🧪 Full Quiz: https://www.passthemsra.com/quizzes/c... (https://www.passthemsra.com/quizzes/c...)
🌐 More: https://www.passthemsra.com (https://www.passthemsra.com) | https://www.freemsra.com (https://www.freemsra.com)
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Episode link: https://play.headliner.app/episode/27...