Rodrigues Kelly Fernandes de Paula, Lima Verônica Castro, Arantes Tiago Eugênio Faria e, Matos Kimble Teixeira Fonseca, Muccioli Cristina
Setor de Úvea/AIDS, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil.
Arq Bras Oftalmol. 2012 Mar-Apr;75(2):140-2. doi: 10.1590/s0004-27492012000200015.
A case of a 14 year-old boy that was admitted complaining of bilateral ocular visual blurring for 2 years is reported. The ophthalmological examination disclosed bilateral mild optic disc hyperemia and swelling, retinal exudation, few retinal hemorrhages, multiple aneurysms, as well as vasculitis. Fluorescein angiography showed extensive peripheral retinal ischemia, dilatations and hyperfluorescence of the vessels walls, and leakage of the optic disc in the late phases in both eyes. This rare case represents an entity characterized by peripheral retinal vascular occlusion, retinal vasculitis, multiple posterior retinal aneurysms, and neuroretinitis (IRVAN). Systemic evaluation and laboratory work-up did not suggest any systemic abnormality. Panretinal laser photocoagulation was performed in both eyes, and the patient was treated with oral prednisone with maintenance of the visual acuity after 1 year of follow-up. Laser treatment should be considered when angiographic evidence of widespread retinal no perfusion is present, and before the development of signs of retinal neovascularization.
报告了一例14岁男孩，因双侧视力模糊2年入院。眼科检查发现双侧轻度视盘充血和肿胀、视网膜渗出、少量视网膜出血、多发动脉瘤以及血管炎。荧光素血管造影显示双眼周边视网膜广泛缺血、血管壁扩张和高荧光，以及晚期视盘渗漏。这个罕见病例代表了一种以周边视网膜血管阻塞、视网膜血管炎、多发视网膜后动脉瘤和神经视网膜炎（IRVAN）为特征的疾病。全身评估和实验室检查未提示任何全身异常。双眼均进行了全视网膜激光光凝治疗，患者接受口服泼尼松治疗，随访1年后视力得以维持。当存在广泛视网膜无灌注的血管造影证据时，以及在视网膜新生血管形成迹象出现之前，应考虑进行激光治疗。
