Acute Idiopathic Hemorrhagic Retinal Vasculitis: Clinical Course and Treatment

Abstract

Purpose To report clinical characteristics and treatment of acute idiopathic hemorrhagicretinal vasculitis (AIHRV)Methods Records of 10 patients (7 female, 3 male) with AIHRV in 12 eyes seen between2012-2018 were reviewed.ResultsMean age at presentation was 32±5 years. Mean LogMAR visual acuity (VA) was1.5±0.8, mean intraocular pressure (IOP) was 10.8±3.3, mean Nare value was152.6±237.8ph/ms, mean central macular thickness (CMT) was 709.5±266.3ð€€€ atpresentation. All patients had extensive preretinal and/or subretinalhemorrhages and vascular sheathing. Fluorescein angiography was performed in7 patients, showing retinal ischemia in 6 and neovascularization in 2 eyes.Serological tests, hematologic and rheumatologic examination were unrewardingin all. Mean follow-up was 13.5±9.9 months. 9 patients received systemiccorticosteroids. Adjunct local corticosteroids and/or intravitreal anti-VEGFinjections were performed when needed. 2 patients with macular edema receivedInterferon alpha-2a, 2 patients received empirical oral valacyclovir and 1 patientreceived azathioprine. Retinal laser photocoagulation was performed in 8 eyes.Ocular complications were vitreous hemorrhage in 2 and increased IOP in 8patients, including 2 with neovascular glaucoma. At [nal visit, mean LogMAR VAwas 0.8±0.8, mean IOP was 15.9±3.8, mean Nare was 22.8±30.9ph/ms, meanCMT was 272.7±70.8ð€€€.ConclusionAIHRV is a challenging condition with unknown etiology and there is no speci[ctreatment. Close follow-up is required for early detection and treatment of ocularcomplications.