Abstract:
Purpose: To highlight clinical and imaging features of 5 patients diagnosed with retinal vasculitis and cryoglobulins. Methods: This retrospective case series describes clinical and angiographic features of retinal vasculitis and serum cryoglobulins and is the most extensive series to our knowledge. Results: Five female patients were diagnosed with retinal vasculitis and serum cryoglobulins. The average age at time of cryoglobulin identification was 46 years (range, 28-72 years), although retinal vasculitis had been present for various durations. Fluorescein angiograms demonstrated large-vessel and small-vessel segmental leakage in 3 patients, only large-vessel segmental leakage in 1 patient, and only small-vessel segmental leakage in 1 patient. Treatment included topical steroids, intraocular steroid injections, oral corticosteroids, oral antimetabolites, and biologic therapy. At the time of this report, 4 of 5 patients had persistent angiographic leakage; however, none had retinal vascular occlusions. Conclusions: Various treatments were efficacious, although resolution was difficult. No patient experienced retinal vascular occlusions or other types of end-organ compromise.
摘要:
目的:强调5例诊断为视网膜血管炎和冷球蛋白的临床和影像学特征。方法:此回顾性病例系列描述了视网膜血管炎和血清冷球蛋白的临床和血管造影特征,是我们所知的最广泛的系列。结果:5例女性患者诊断为视网膜血管炎和血清冷球蛋白。冷球蛋白鉴定的平均年龄为46岁(范围,28-72岁),尽管视网膜血管炎已经出现了不同的持续时间。荧光血管造影显示3例患者大血管和小血管节段渗漏,仅1例患者出现大血管节段性漏,1例患者仅有小血管节段性渗漏。治疗包括局部类固醇,眼内类固醇注射,口服皮质类固醇,口服抗代谢药,和生物治疗。在本报告编写之时,5例患者中有4例出现持续性血管造影渗漏;然而,没有视网膜血管阻塞。结论:各种治疗方法是有效的,虽然决议是困难的。没有患者经历视网膜血管阻塞或其他类型的终末器官损害。