Thomas Claire, Zubair Talhah, Monteagudo Luke, Lotfi-Emran Sahar, Yamanuha Justin
University of Minnesota Medical School, Twin Cities Campus, Minneapolis, MN, USA.
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA.
J Vitreoretin Dis. 2023 Oct 9;8(2):181-185. doi: 10.1177/24741264231203788. eCollection 2024 Mar-Apr.
To highlight clinical and imaging features of 5 patients diagnosed with retinal vasculitis and cryoglobulins. This retrospective case series describes clinical and angiographic features of retinal vasculitis and serum cryoglobulins and is the most extensive series to our knowledge. Five female patients were diagnosed with retinal vasculitis and serum cryoglobulins. The average age at time of cryoglobulin identification was 46 years (range, 28-72 years), although retinal vasculitis had been present for various durations. Fluorescein angiograms demonstrated large-vessel and small-vessel segmental leakage in 3 patients, only large-vessel segmental leakage in 1 patient, and only small-vessel segmental leakage in 1 patient. Treatment included topical steroids, intraocular steroid injections, oral corticosteroids, oral antimetabolites, and biologic therapy. At the time of this report, 4 of 5 patients had persistent angiographic leakage; however, none had retinal vascular occlusions. Various treatments were efficacious, although resolution was difficult. No patient experienced retinal vascular occlusions or other types of end-organ compromise.
突出5例诊断为视网膜血管炎合并冷球蛋白血症患者的临床和影像学特征。本回顾性病例系列描述了视网膜血管炎和血清冷球蛋白血症的临床及血管造影特征,据我们所知,这是最全面的系列研究。5例女性患者被诊断为视网膜血管炎合并血清冷球蛋白血症。冷球蛋白确诊时的平均年龄为46岁(范围28 - 72岁),尽管视网膜血管炎已存在不同时长。荧光素血管造影显示,3例患者存在大血管和小血管节段性渗漏,1例患者仅存在大血管节段性渗漏,1例患者仅存在小血管节段性渗漏。治疗包括局部应用类固醇、眼内注射类固醇、口服皮质类固醇、口服抗代谢药物和生物治疗。在本报告发布时,5例患者中有4例血管造影仍存在持续性渗漏;然而,无一例发生视网膜血管阻塞。尽管病情难以缓解,但各种治疗均有效。没有患者出现视网膜血管阻塞或其他类型的终末器官损害。