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双侧特发性视网膜血管炎、动脉瘤样扩张及视神经视网膜病变综合征病例的进一步观察

Further observations on a bilateral IRVAN syndrome case.

作者信息

Rodríguez Álvaro, Carpio-Rosso Willy, Rodríguez Francisco J

机构信息

Fundación Oftalmológica Nacional, Carrera 13 #13-50, Bogotá D.C., Colombia.

Universidad del Rosario, Bogotá D.C., Colombia.

出版信息

Int Ophthalmol. 2019 May;39(5):1179-1186. doi: 10.1007/s10792-018-0917-z. Epub 2018 Jun 14.

Abstract

PURPOSE

Reporting clinical features of the late course of the disease after long-term follow-up in a bilaterally affected patient with idiopathic retinitis, vasculitis, retinal aneurysms and neuroretinitis (IRVAN) and new peripheral retinal findings on wide-field angiography and multimodal imaging.

METHODS

This was a retrospective observational study, based on current diagnostic studies including wide-field fluorescein angiography, optical coherence tomography (OCT) and treatment of aneurysms with argon laser photocoagulation.

RESULTS

A 21-year-old female with bilateral IRVAN syndrome-stage 2 in the right eye and stage 3 in the left eye-previously treated bilaterally with laser photocoagulation for retinal macroaneurysms and ischemic areas between 1985 and 1992. Follow-up interrupted on two occasions, with subsequent fundus re-examinations confirming the prevention of retinal neovascularization in both eyes, as recently evidenced on wide-field angiography.

CONCLUSIONS

A case of bilateral IRVAN disease with multiple retinal aneurysms, neuroretinitis and peripheral capillary nonperfusion successfully treated with laser photocoagulation, maintaining normal visual acuity in one eye and preventing retinal neovascular complications.

摘要

目的

报告一名双侧受累的特发性视网膜病变、血管炎、视网膜动脉瘤和神经视网膜炎(IRVAN)患者长期随访后的疾病晚期临床特征,以及广角血管造影和多模态成像显示的新的周边视网膜表现。

方法

这是一项回顾性观察研究,基于当前的诊断研究,包括广角荧光素血管造影、光学相干断层扫描(OCT)以及用氩激光光凝治疗动脉瘤。

结果

一名21岁女性,右眼为双侧IRVAN综合征2期,左眼为3期,曾在1985年至1992年间双眼接受激光光凝治疗视网膜大动脉瘤和缺血区域。随访曾中断两次,随后的眼底复查证实双眼均预防了视网膜新生血管形成,这在最近的广角血管造影中得到了证实。

结论

一例双侧IRVAN病伴多发视网膜动脉瘤、神经视网膜炎和周边毛细血管无灌注,经激光光凝成功治疗,一只眼保持正常视力,预防了视网膜新生血管并发症。

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