Combination anti-VEGF and corticosteroid therapy for idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome.
Vision loss associated with the idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome most commonly occurs from macular edema or complications related to neovascularization. The authors present a case of advanced IRVAN associated with a massive exudative response characterized by peripheral retinal telangiectasias, exudative retinal detachment, and macular edema with lipid maculopathy. The patient was managed successfully with visual acuity from hand motion to 20/150 using a combination of local corticosteroids, intravitreal bevacizumab, panretinal photocoagulation, and eventually pars plana vitrectomy for progressive vitreomacular traction. VEGF- and non-VEGF-mediated mechanisms appear to be involved in the pathogenesis of IRVAN given the efficacy of combination therapy. [ophthalmic surg lasers imaging retina. 2013;44:599-602.].
Gagan K
GK
Sawhney
John F
JF
Payne
Robin
R
Ray
Sonia
S
Mehta
Chris S
CS
Bergstrom
Steven
S
Yeh
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000783:Aneurysm / Q000175:diagnosis / Q000628:therapy*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D008028:Light Coagulation / Q000379:methods; D031300:Retinal Vasculitis / Q000175:diagnosis / Q000628:therapy*; D012173:Retinitis / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods
D000305:Adrenal Cortex Hormones; D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab