Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review
Purpose: To review the clinical features, diagnosis, and treatment of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) and to report a case with the use of ultra-widefield fluorescein angiography (UWFA) for confirming the precise staging of IRVAN and aid in early treatment. The p...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/10/1467 |
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| author | Ping-Ping Meng Chun-Ju Lin Ning-Yi Hsia Chun-Ting Lai Henry Bair Jane-Ming Lin Wen-Lu Chen Yi-Yu Tsai |
| author_facet | Ping-Ping Meng Chun-Ju Lin Ning-Yi Hsia Chun-Ting Lai Henry Bair Jane-Ming Lin Wen-Lu Chen Yi-Yu Tsai |
| author_sort | Ping-Ping Meng |
| collection | DOAJ |
| description | Purpose: To review the clinical features, diagnosis, and treatment of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) and to report a case with the use of ultra-widefield fluorescein angiography (UWFA) for confirming the precise staging of IRVAN and aid in early treatment. The patient improved after being treated with intravitreal aflibercept injection. Results: A 26-year-old female complained of progressive blurred vision OD for one week. Her BCVA was 0.6 OD and 1.0 OS. Fundus examination showed vitritis, retinal hemorrhage, and vasculitis over bilateral eyes. Fluorescein angiography (FA) with a 55 degree of view revealed aneurysmal dilations of the peripapillary arteriole, peripapillary focal leakage, venous leakage, and capillary nonperfusion area. Stage 2 IRVAN was impressed OU. Oral prednisolone was administered. After four months, she experienced decreased visual acuity OS. Optical coherence tomography (OCT) revealed subretinal and intraretinal fluid with hyperreflective material. One posterior subtenon triamcinolone and one intravitreal aflibercept injection were performed OS, and macular edema subsided. A 105-degree ultra-widefield fluorescein angiography (UWFA) showed multiple peripheral background hypofluorescence areas corresponding to capillary nonperfusion. Retinal neovascularization (NV) was found OS, which had not been revealed by the previous 55-degree FA. Stage 3 IRVAN was made OS and panretinal laser photocoagulation (PRP) was performed. Oral prednisone and cyclosporine were prescribed. Her vision improved to 1.0 OU. Conclusion: UWFA provides visualization of peripheral retinal pathology and for precise staging. It also had direct implications in the follow-up and treatment strategy. |
| first_indexed | 2024-03-09T19:50:36Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-09T19:50:36Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Medicina |
| spelling | doaj.art-10782f332e0d457ea948d123320a68442023-11-24T01:11:43ZengMDPI AGMedicina1010-660X1648-91442022-10-015810146710.3390/medicina58101467Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature ReviewPing-Ping Meng0Chun-Ju Lin1Ning-Yi Hsia2Chun-Ting Lai3Henry Bair4Jane-Ming Lin5Wen-Lu Chen6Yi-Yu Tsai7Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, TaiwanPurpose: To review the clinical features, diagnosis, and treatment of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) and to report a case with the use of ultra-widefield fluorescein angiography (UWFA) for confirming the precise staging of IRVAN and aid in early treatment. The patient improved after being treated with intravitreal aflibercept injection. Results: A 26-year-old female complained of progressive blurred vision OD for one week. Her BCVA was 0.6 OD and 1.0 OS. Fundus examination showed vitritis, retinal hemorrhage, and vasculitis over bilateral eyes. Fluorescein angiography (FA) with a 55 degree of view revealed aneurysmal dilations of the peripapillary arteriole, peripapillary focal leakage, venous leakage, and capillary nonperfusion area. Stage 2 IRVAN was impressed OU. Oral prednisolone was administered. After four months, she experienced decreased visual acuity OS. Optical coherence tomography (OCT) revealed subretinal and intraretinal fluid with hyperreflective material. One posterior subtenon triamcinolone and one intravitreal aflibercept injection were performed OS, and macular edema subsided. A 105-degree ultra-widefield fluorescein angiography (UWFA) showed multiple peripheral background hypofluorescence areas corresponding to capillary nonperfusion. Retinal neovascularization (NV) was found OS, which had not been revealed by the previous 55-degree FA. Stage 3 IRVAN was made OS and panretinal laser photocoagulation (PRP) was performed. Oral prednisone and cyclosporine were prescribed. Her vision improved to 1.0 OU. Conclusion: UWFA provides visualization of peripheral retinal pathology and for precise staging. It also had direct implications in the follow-up and treatment strategy.https://www.mdpi.com/1648-9144/58/10/1467ultra-widefield fluorescein angiographyidiopathic retinal vasculitisaneurysms and neuroretinitispanretinal laser photocoagulationcase report |
| spellingShingle | Ping-Ping Meng Chun-Ju Lin Ning-Yi Hsia Chun-Ting Lai Henry Bair Jane-Ming Lin Wen-Lu Chen Yi-Yu Tsai Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review Medicina ultra-widefield fluorescein angiography idiopathic retinal vasculitis aneurysms and neuroretinitis panretinal laser photocoagulation case report |
| title | Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review |
| title_full | Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review |
| title_fullStr | Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review |
| title_full_unstemmed | Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review |
| title_short | Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis—Case Report and Literature Review |
| title_sort | use of ultra widefield fluorescein angiography to guide the treatment to idiopathic retinal vasculitis aneurysms and neuroretinitis case report and literature review |
| topic | ultra-widefield fluorescein angiography idiopathic retinal vasculitis aneurysms and neuroretinitis panretinal laser photocoagulation case report |
| url | https://www.mdpi.com/1648-9144/58/10/1467 |
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