Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation

Marta Świerczyńska; Lech Sedlak; Paweł Wąs; Marta Nowak; Mariola Dorecka; Ewa Mrukwa-Kominek

doi:10.5114/ko.2022.118406

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Klinika Oczna / Acta Ophthalmologica Polonica

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1/2023
vol. 125

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abstract:

Case report

Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation

Marta Świerczyńska

^{1, 2}

,

Lech Sedlak

^{1, 2}

,

Paweł Wąs

^{1, 2}

,

Marta Nowak

^{1, 2, 3}

,

Mariola Dorecka

^{1, 2}

,

Ewa Mrukwa-Kominek

^{1, 2}

Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

KLINIKA OCZNA 2023, 125, 1: 50-55

DOI: https://doi.org/10.5114/ko.2022.118406

Online publish date: 2022/09/06

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AMA

Świerczyńska M, Sedlak L, Wąs P, Nowak M, Dorecka M, Mrukwa-Kominek E. Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation. Klinika Oczna / Acta Ophthalmologica Polonica. 2023;125(1):50-55. doi:10.5114/ko.2022.118406.

APA

Świerczyńska, M., Sedlak, L., Wąs, P., Nowak, M., Dorecka, M.,  & Mrukwa-Kominek, E. (2023). Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation. Klinika Oczna / Acta Ophthalmologica Polonica, 125(1), 50-55. https://doi.org/10.5114/ko.2022.118406

Chicago

Świerczyńska, Marta, Lech Sedlak, Paweł Wąs, Marta Nowak, Mariola Dorecka,  and Ewa Mrukwa-Kominek. 2023. "Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation". Klinika Oczna / Acta Ophthalmologica Polonica 125 (1): 50-55. doi:10.5114/ko.2022.118406.

Harvard

Świerczyńska, M., Sedlak, L., Wąs, P., Nowak, M., Dorecka, M.,  and Mrukwa-Kominek, E. (2023). Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation. Klinika Oczna / Acta Ophthalmologica Polonica, 125(1), pp.50-55. https://doi.org/10.5114/ko.2022.118406

MLA

Świerczyńska, Marta et al. "Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation." Klinika Oczna / Acta Ophthalmologica Polonica, vol. 125, no. 1, 2023, pp. 50-55. doi:10.5114/ko.2022.118406.

Vancouver

Świerczyńska M, Sedlak L, Wąs P, Nowak M, Dorecka M, Mrukwa-Kominek E. Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation. Klinika Oczna / Acta Ophthalmologica Polonica. 2023;125(1):50-55. doi:10.5114/ko.2022.118406.

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Introduction
Idiopathic retinal vasculitis, aneurysms and neuro- retinitis (IRVAN) syndrome is a rare clinical entity of unknown etiology with vision threatening potentials.

Case presentation
In this article, we present a case of a 38-year-old woman complaining of decreased visual acuity OU (oculi utriusque) for a duration of 3 months. On admission, the best-corrected visual acuity (BCVA) was 5/50 in the right eye (RE) and 2/50 in the left eye (LE). Mild rubeosis iridis in the LE was noted. Posterior segment examination revealed hemorrhage floaters in the vitreous chamber, macular edema, hemorrhages and aneurysms in OU. Fundus fluorescein angiography (FFA) showed the presence of numerous microaneurysms, enhancement of vascular contrast, leakage on the optic nerve disc, as well as extensive areas of non-perfusion in the middle peripheral retina in OU. Based on constellation of clinical and angiographic features as well as the negative extensive workup, a diagnosis of IRVAN was established. Anti-inflammatory, immunosuppressive and hemostatic treatments were applied, and panretinal photocoagulation was performed in OU. In the next stage, due to visual impairment, persistent vascular leak, macular edema in OU, anti-vascular endothelial growth factor (VEGF) intravitreal injections were given. As a result, BCVA increased to 5/12 in the RE and 5/50 in the LE. The patient remains under regular follow-up.

Conclusions
Late diagnosis and lack of appropriate treatment of IRVAN syndrome may lead to complete loss of vision due to complications secondary to lack of perfusion. It is important for ophthalmologists to improve understanding of this disease and manage the symptoms as soon as possible.

keywords:

Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN): a case report and outcomes of 1.5-year observation

Marta Świerczyńska 1, 2 , Lech Sedlak 1, 2 , Paweł Wąs 1, 2 , Marta Nowak 1, 2, 3 , Mariola Dorecka 1, 2 , Ewa Mrukwa-Kominek 1, 2

IRVAN syndrome, retinal vasculitis, aneurysmal dilatation, neuroretinitis, panretinal photocoagulation

Marta Świerczyńska

^{1, 2}

,

Lech Sedlak

^{1, 2}

,

Paweł Wąs

^{1, 2}

,

Marta Nowak

^{1, 2, 3}

,

Mariola Dorecka

^{1, 2}

,

Ewa Mrukwa-Kominek

^{1, 2}