Reperfusion of retinal ischemia in retinal occlusive vasculitis with nicotinic acid and infliximab in Adamantiades-Behçet's disease
| Autor: | Quan Dong Nguyen, Amir Akhavanrezayat, Doan Luong Hien, Huy V. Nguyen, Brandon Pham, Cigdem Yasar, Sherin Lajevardi, Ahmad Al-Moujahed, Huy Luong Doan, Than Trong Tuong Ngoc |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual acuity Retinal ischemia Vaso-occlusive retinal vasculitis Case Report Behcet's disease Niacin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine lcsh:Ophthalmology Ophthalmology medicine medicine.diagnostic_test Behçet's disease Retinal vasculitis business.industry Retinal medicine.disease Fluorescein angiography Nicotinic acid chemistry lcsh:RE1-994 030221 ophthalmology & optometry Optic nerve medicine.symptom Vasculitis business 030217 neurology & neurosurgery Uveitis |
| Zdroj: | American Journal of Ophthalmology Case Reports American Journal of Ophthalmology Case Reports, Vol 21, Iss, Pp 101027-(2021) |
| ISSN: | 2451-9936 |
| Popis: | Purpose To describe a case of ischemic retinal vasculitis in Adamantiades-Behcet disease (ABD) that demonstrated significant resolution of retinal ischemia following treatment with nicotinic acid and infliximab.Observations: A 12-year-old male with a history of recurrent oral ulcers, fevers, and failure to thrive was admitted to the hospital with fever, oral and perirectal mucositis, and poor oral intake one month before presentation to uveitis clinic. He was suspected to have ABD and was treated with three doses of intravenous (IV) methylprednisolone (30 mg/kg/day) which led to improvement in his systemic symptoms. One week after admission, he complained of decreased vision in both eyes (OU), during which he was found to have anterior uveitis in OU and was referred to the Uveitis Clinic. Upon examination, his visual acuity was 20/80 in OU. Intraocular pressures were within normal limits. Anterior chamber evaluation revealed 0.5+ cells and 1.5+ flare in OU. Posterior examination revealed pale optic nerve, sclerosis and vascular sheathing of retinal arteries, and collateral vessels in OU. Fluorescein angiography (FA) showed optic disc leakage and widespread retinal ischemia in OU. The patient was diagnosed with retinal occlusive vasculitis associated with ABD. He was initially treated with infliximab (5 mg/kg), systemic methylprednisolone, and mycophenolate mofetil. Three months later, his BCVA improved to 20/70 OU with slight improvement of retinal ischemia on FA. Nicotinic acid was added to his treatment regimen. Due to logistic challenges, he did not receive infliximab treatment during the subsequent three months. However, three months after beginning nicotinic acid therapy, FA revealed significant improvement of his retinal ischemia OU. Conclusion: To our knowledge, the index report is the first to show that nicotinic acid may improve retinal ischemia in vaso-occlusive retinal vasculitis and be an integral part of the treatment regimen of this sight-threatening condition. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|