ABSTRACT
A 54-year-old male sustained ocular trauma with a projectile. Examination of the right eye revealed an intraocular foreign body (IOFB) adjacent to the optic nerve head, vitritis, vitreous hemorrhage, and translucent perivascular sheathing of the retinal vessels in all quadrants suggesting frosted branch angiitis (FBA). The patient underwent vitrectomy with removal of the IOFB and silicone oil tamponade under steroid cover. With continued use of systemic and topical steroids after surgery, complete resolution of FBA and improvement in vision were noted in a week. Prompt resolution of FBA after IOFB removal points toward a strong association between the presence of IOFB and FBA.
ABSTRACT
PURPOSE: A case of frosted branch angiitis in Kikuchi-Fujimoto disease is reported. CASE SUMMARY: A 33-year-old male complained of a sudden decrease in visual acuity that developed in both eyes 5 days prior. He suffered from a headache, chills, myalgia, and flank pain 1 week before. The initial best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.2 in the left eye. On slit lamp examination, no inflammatory finding was observed in the anterior chamber and vitreous body of both eyes. On fundus examination, a diffuse vascular sheathing-like frosted branch was found in the retinal vessels, and retinal hemorrhage was observed. Fluorescein angiography showed staining and leakage of dye along the vascular sheathing. Serological findings were negative, showing no evidence of an autoimmune disease or viral infection. Neck ultrasonography revealed non-tender left cervical lymph node enlargement >1 cm in diameter. Ultrasound-guided fine needle aspiration cytology showed findings compatible with Kikuchi-Fujimoto disease, including necrotic changes and pronounced karyorrhexis, plus histiocyte and lymphocyte infiltration without neutrophils. We started systemic steroid therapy. One month after treatment, the BCVA of both eyes improved to 1.0. CONCLUSIONS: In patients with frosted branch angiitis, systemic disease such as Kikuchi-Fujimoto disease should be considered.
Subject(s)
Adult , Humans , Male , Anterior Chamber , Autoimmune Diseases , Biopsy, Fine-Needle , Chills , Flank Pain , Fluorescein Angiography , Headache , Histiocytes , Histiocytic Necrotizing Lymphadenitis , Lymph Nodes , Lymphocytes , Myalgia , Neck , Neutrophils , Retinal Hemorrhage , Retinal Vessels , Slit Lamp , Ultrasonography , Vasculitis , Visual Acuity , Vitreous BodyABSTRACT
We report an unusual case of unilateral frosted branch angiitis associated with Behcet's disease, including a review of previously reported cases. A 39-year-old male with history of recurrent oral and genital ulcers presented with visual loss in his left eye. Fundus findings demonstrated occlusive retinal vasculitis resembling acute frosted branch angiitis. Laboratory examinations including viral markers revealed no abnormal findings except positive HLA-B51. The patient was treated with systemic steroid and cyclosporine. Six months after presentation, new oral ulcers and pseudofolliculitis appeared, and he was diagnosed with Behcet's disease following rheumatology consultation. During follow-up, there was no change in visual acuity of hand movement, and disc neovascularization developed even after complete panretinal photocoagulation. Ocular manifestations of Behcet's disease can present as unilateral frosted branch angiitis, and may consecutively involve in both eyes. Early immunosuppressive treatment is recommended.
Subject(s)
Adult , Humans , Male , Behcet Syndrome/complications , Diagnosis, Differential , Fluorescein Angiography , Fundus Oculi , Magnetic Resonance Imaging , Retinal Artery/pathology , Retinal Vasculitis/diagnosisABSTRACT
PURPOSE: Frosted branch angiitis is a rare retinal disease with the characteristic sheathing in the retinal vessels. We report a typical case of this disease. METHODS: A thirty-year-old woman complained of sudden decrease of visual acuity developed in both eyes three days ago. Visual acuity was 0.4 with several inflammatory cells in the anterior chambers of both eyes. There were diffuse vascular sheathing like frosted branch in both retinas. Fluorescein angiogram showed staining and leakage of dye along the vascular sheathing. RESULTS: Visual acuity recovered to 1.0 and retinal findings returned normal 2 weeks after treatment with the low dose of systemic steroid. There was no recurrence during follow-up period. CONCLUSIONS: Typical frosted branch angiitis occurs suddenly in both eyes of the young, and it responds well to treatment with the low dose of systemic steroid.