Department of Ophthalmology, Vita-Salute San Raffaele University Milan, Italy Department of Ophthalmology.
IRCCS San Raffaele Scientific Institute, Milan, Italy.
Retin Cases Brief Rep. 2024 Jul 1;18(4):476-480. doi: 10.1097/ICB.0000000000001417.
Our aim was to report a comprehensive multimodal imaging case of unilateral frosted branch angiitis in a 40-year-old White woman.
Case report involving clinical examination, ultra-wide field fundus photograph, ultra-wide field fluorescein angiography, optical coherence tomography (OCT) and OCT angiography.
A 40-year-old patient presented with unilateral acute vision loss. On fundus examination, extensive retinal veins sheathing, macular edema, and vascular congestion were observed while ultra-wide field fluorescein angiography revealed a hyperfluorescent "hot" optic disc and blood retinal barrier disruption. Optical coherence tomography angiography displayed foveal avascular zone enlargement and excluded papillary neovascularization. Extensive laboratory workup for infectious, autoimmune, and inflammatory disorders was negative; thus, a diagnose of acute idiopathic unilateral frosted branch angiitis was made. Intravitreal injection of dexamethasone implant was administered with a good clinical response.
Multimodal imaging is crucial to correctly diagnose and treat frosted branch angiitis. To the best of our knowledge, the use of optical coherence tomography angiography as a complementary tool to the diagnostic process in frosted branch angiitis has been described in literature just once as a photographic essay of cytomegalovirus-related frosted branch angiitis 1 and it might be of great value for better characterizing clinical features of this disorder and for following disease activity in a noninvasive fashion.
我们旨在报告一例 40 岁白人女性单侧雪笤状血管炎的综合多模态成像病例。
病例报告包括临床检查、超广角眼底照相、超广角荧光素血管造影、光学相干断层扫描（OCT）和 OCT 血管造影。
一名 40 岁患者出现单侧急性视力丧失。眼底检查发现广泛的视网膜静脉鞘膜、黄斑水肿和血管充血，超广角荧光素血管造影显示高荧光“热点”视盘和血视网膜屏障破坏。OCT 血管造影显示中心凹无血管区扩大，排除了乳头新生血管。广泛的感染、自身免疫和炎症性疾病的实验室检查均为阴性；因此，诊断为急性特发性单侧雪笤状血管炎。给予玻璃体内注射地塞米松植入剂，临床反应良好。
多模态成像对于正确诊断和治疗雪笤状血管炎至关重要。据我们所知，OCT 血管造影作为雪笤状血管炎诊断过程中的辅助工具，仅在一篇关于巨细胞病毒相关性雪笤状血管炎的摄影文章中被描述过 1，它可能对更好地描述该疾病的临床特征和以非侵入性方式监测疾病活动非常有价值。
