Ottenberg D., Kathke M. A., Kreusel K. M., Kellner U., Foerster M. H.

Augenklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin

Objective: Acute idiopathic frosted branch angiitis is a rare retinal vasculitis mostly seen in young and otherwise healthy people. To the best of our knowledge we report the first case observed in Germany.
Patient an methods: A 16 year old female patient with frosted branch angiitis underwent treatment with oral prednisolone. The clinical course was observed and documented angiographically over a 1 year period.
Results: Initially the patient suffered from sudden and severe visual loss and reduced colour vision. The visual acuity was 20/200 in both eyes. The anterior segments were normal. Pathological findings on ophthalmoscopy were severe sheathing along retinal arteries and veins from optic disc to periphery and a mild macular oedema. Visual field testing showed an enlarged blind spot and paracentral scotomas. In the desaturated Panel D15-test multiple errors without a typical axis of confusion were detected. Fluorescein angiography showed leakage of multiple vessels in the late stages. Further investigations gave no sign of any other associated general disease. Under systemic corticosteroid therapy visual acuity improved within three days to 20/30 in the right eye and 20/50 in the left eye. After five weeks visual acuity was 20/20 in both eyes. The paravascular sheathings disappeared and with resorption of macular oedema hard exudates developed in the posterior pole. These exsudates disappeared with time.
Conclusions: Acute idiopathic frosted branch angiitis is a rare vasculitis with severe functional loss that recovers rapidly under systemic therapy with corticosteroids and has a good prognosis.

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