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Retinite idiopática, vasculite, aneurismas e neurorretinite (IRVAN): relato de caso

DOI: 10.1590/S0004-27492012000200015

Keywords: uveitis, retinitis [diagnosis], aneurysm [diagnosis], retinal vasculitis [diagnosis], fluorescein angiography, glucocorticoids [therapeutic use], syndrome, humans, male, adolescent, case reports.

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Abstract:

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.

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