title: SCLEROMYXEDEMA WITH RETINAL VASCULITIS AND MACULAR EDEMA.
abstract: OBJECTIVE
  To describe the findings and clinical course of a patient with scleromyxedema complicated by retinal vasculitis and macular edema.
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  A 64-year old Caucasian woman with recently diagnosed, biopsy proven scleromyxedema presented with decreased visual acuity (20/50 OD; 20/100 OS) due to retinal vasculitis and macular edema. She received intravitreal bevacizumab and subtenon's triamcinolone acetonide for the macular edema, and bilateral pars plana vitrectomies were required for vitreous hemorrhages. Monthly intravenous infusions of immunoglobulins (IVIG) resulted in resolution of the macular edema and vasculitis, and stabilization of the VA (20/40 OD; counting fingers at 6 feet OS).
  
  
  CONCLUSIONS
  Scleromyxedema may be complicated by retinal vasculitis and macular edema. Treatment with corticosteroids and vascular endothelial growth factor inhibitors may be minimally effective but IVIG should be considered for both the ocular and systemic findings.
authors.affiliation: *Department of Medicine and Nutrition, University of Guanajuato, Leon Guanajuato, Mexico; and Departments of †Ophthalmology, and ‡Dermatology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Karen I
authors.initials: KI
authors.lastname: Gutiérrez-Aguirre
authors.forename: Michael W
authors.initials: MW
authors.lastname: Stewart
authors.forename: Jason C
authors.initials: JC
authors.lastname: Sluzevich
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D031300:Retinal Vasculitis / Q000188:drug therapy* / Q000209:etiology; D053718:Scleromyxedema / Q000150:complications*; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D007136:Immunoglobulins; D014221:Triamcinolone; D000068258:Bevacizumab