Abstract:AIM:To investigate the therapeutic outcomes of idiopathic retinal vasculitis, aneurisms and neuroretinitis(IRVAN)syndrome by different treatments.
METHODS:Seven patients(14 eyes)with IRVAN were enrolled in this study and divided into different stages. There were 4 eyes in stage Ⅱ and 10 eyes in stage Ⅲ. The visual acuity(VA)was ≥0.6 in 6 eyes, 0.3 in 4 eyes, and ≤0.1 in 4 eyes. Treatment involved retinal laser photocoagulation for peripheral retinal ischemia area in the 4 eyes in stage Ⅱ and panretinal laser photocoagulation(PRP)for the 10 eyes in stage Ⅲ. Two eyes in stage Ⅲ were also treated with intravitreal injection of ranibizumab and 4 eyes with vitrectomy before PRP. Visual acuity and fundus situations were measured after the treatments. The follow-up time was 6mo ~ 10a.
RESULTS:After treatments, the final VA was improved in 6 eyes, remaining unchanged in 6 eyes, and decreased after improved in 2 eyes. It was as following:≥0.6 in 9 eyes, 0.3~0.6 in 4 eyes, and ≤0.1 in 1 eyes. Four eyes in stage Ⅱ maintained a good vision, but one of them had a new ischemia area. We treated it with PRP and there was no progression now. In stage Ⅲ, there were 2 eyes with unchanged VA, 2 eyes with improved VA, 2 eyes with improved VA after giving ranibizumab, 4 eyes with vitreous hemorrhage and with better VA after treatments, and in the 4 eyes, 2 eyes kept stable and another two had recurrent vitreous hemorrhage for several times and ended with poor vision. Fundus examination showed the closure of hemorrhage area and optic disc or retinal neovascularization shrinked.
CONCLUSION:PRP is effective for eyes in stage Ⅱ. Eyes in stage Ⅲ could be treated with intravitreal injection of ranibizumab or vitrectomy in addition to PRP. Early PRP is effective to stop the progression.