"Dalen Fuch" nodules are seen in
Ans. c (Sympathetic ophthalmia) (Ref. Schlote, Pocket Atlas of Ophthalmology, p. 132).Dalen-Fuchs Nodules (chorioretinal lesions) are small, discrete, yellow, elevated infiltrates are commonly seen in the midperipheral fundus of patients with sympathetic uveitis. They consist of lymphocytes and epithelioid cell collections between Bruch's membrane and retinal pigment epithelium, although not pathognomonic for Sympathetic ophthalmia, are quite suggestive of this condition; They may be found in VKH syndrome.SYMPATHETIC OPHTHALMIA# Sympathetic ophthalmia is a bilateral, granulomatous panuveitis that classically occurs following a penetrating injury of the eye with uveal involvement.# It can also result from ocular surgery.# Etiology/pathogenesis- T cell-mediated autoimmune reaction, caused by release of uveal antigens (probably from melanocytes).- Genetic predisposition (association with HLADRB1* 04 and DQA1*03).# Epidemiology- Very rare; Manifestation may be days to many years after the causative trauma (90% within one year).# Features:- The visual acuity is variable.- Greasy-appearing deposits on the back of the cornea- Variable anterior chamber inflammation- Inflammatory cells in the vitreous.- Choroidal thickening, Papillitis, Retinal vascular sheathing- Fuchs-Dalen nodules (small white infiltrates in the middle periphery of the fundus)- Macular edema, Exudative retinal detachment, and Optic atrophy.# Diagnosis- Diagnosis is made clinically when panuveitis from other causes is excluded.# Differential diagnosis- Endophthalmitis, Other forms of panuveitis, and Masquerade syndromes (intraocular lymphoma).# Treatment# There is high risk of blindness without adequate treatment if bilateral.# Administration of local and systemic corticosteroids constitutes the basic therapy.# Use of immunosuppressants (e.g., cyclosporine A) is often also required.# Prognosis# Recurrences are frequent following reduction or cessation of therapy.# Long-term or even lifetime treatment is therefore necessary.# The most common complications interfering with vision are macular edema, secondary cataract, and secondary glaucoma.Also remember:Berlin, Koeppe, Busacca nodules are found on iris in granulomatous uveitis. Koeppe's are seen on papillary border, while Busacca are found mid-iris. Berlin are present in angle.6
Hypertensive retinopathy
Diabetic retinopathy
Sympathetic ophthalmia
All of the above
Uveal Tract