Bilateral Retinal Vasculitis with Arterial Aneurysms
Bilaterálna retinálna vaskulitída s arteriálnymi aneuryzmami
Autori predstavujú neobvyklý a vzácny obraz obojstrannej retinálnej vaskulitídy, postihujúci kmeň centrálnej retinálnej artérie a jej kvadrantové vetvy do druhého vetvenia. Prominentným prejavom boli: práškovite skalený sklovec, oklúzia vetvy centrálnej retinálnej artérie, segmentárna periarteriálna infiltrácia, opúzdrenie arterií, arteriálne aneuryzmy, edém terča zrakového nervu, neperfúzna periféria sietnice a komplikácie, ktoré z tohoto stavu vyplývali. V priebehu 13 rokov pozorovania a liečby jedno oko osleplo 3 roky od začiatku ochorenia. Druhé oko s podobným počiatočným priebehom ochorelo dva roky po prvom oku. Pre podobný priebeh s hroziacimi následkami sa zahájila kortikosteroidná a imunosupresívna liečba, rozsiahla fotokoagulácia neperfúznej periférie sietnice a chirurgický vitreoretinálny zákrok, až sa dosiahla remisia s deficitom zrakových funkcií. Rozsiahle fyzikálne, laboratórne a zobrazovacie vyšetrovania nepriniesli dôkaz systémovej choroby a objasnenie etiológie. Chorobu sme v súlade s literárnymi údajmi zaradili do kategórie idiopatickej retinálnej vaskulitídy.
Kľúčové slová:
idiopatická retinálna vaskulitída, fluoresceinová angiografia, fotokoagulačná liečba, kortikosteroidná a imunosupresívna liečba, vitreoretinálna chirurgia.
Authors:
T. Streicher 1; J. Špirková 1; Ľ. Gürtler 2
Authors‘ workplace:
Očné oddelenie NsP, Bojnice, primárka MUDr. J. Špirková
1; Oddelenie klinickej imunológie FNsP sv. Cyrila a Metoda, Bratislava
primár MUDr. Ľ. Gürtler
2
Published in:
Čes. a slov. Oftal., 62, 2006, No. 2, p. 79-85
Overview
The authors reported unusual and rare condition of bilateral retinal vasculitis primarily affecting the central retinal artery at the nerve head and its 4 main branches. The most striking feature was the presence of the diffuse vitreous cells, occlusion of branch retinal artery, segmental periarterial infiltration, arterial sheating, retinal arterial aneurysms, disc swelling, peripheral retinal non perfusion and their complications. During 13 year’s observation and treatment one eye went blind 3 years after initial examination. Second eye started the same clinical course two years after beginning of the disease. To avoid similar devastating course of the disease we started systemic steroids and immunosuppressive therapy, followed by photocoagulation of nonperfused peripheral retina and vitreoretinal surgery. We achieved stabilization of the disease with decreased visual functions. Comprehensive systemic work-up was unrevealing, no clear etiology was identified and diagnosis of idiopathic retinal vasculitis was made.
Key words:
idiopathic retinal vasculitis, fluorescein angiography, photocoagulation, systemic steroids and immunosuppressive therapy, vitreoretinal surgery
Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2006 Issue 2
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