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Impressum
Regression of optic disc neovascularization in retinal vasculitis by immunosuppressive treatment
Wenkel H., Krist D.
Department of Ophthalmology, University Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen
Purpose: Occlusive retinal vasculitis frequently results in retinal
neovascularization. We report on 5 patients with optic disc neovascularization
in which systemic immunosuppression alone resulted in regression of neovascularization.
Patients and methods: In a retrospective fashion we re-evaluated
all 49 patients (58 eyes) with occlusive retinal vasculitis out of 173
patients with retinal vasculitis diagnosed by fluorescence angiography
between 1988 and 1998. Occlusive retinal vasculitis was characterized
by either retinal capillary drop out or retinal (NVE) or optic disc (NVD)
neovascularization.
Results: NVEs were only seen in eyes with retinal capillary drop
out. In 5/13 eyes with NVD no major retinal capillary drop out was visible.
Three of these eyes presented vitreous hemorrhages. The clinical diagnosis
was retinal vasculitis of unknown origin (4/5) or Behcet's disease (1/5).
These patients received initial treatment with high dosage of corticosteroids
and 3 patients were also treated with additional systemic immunosuppression
using cyclosporine A (2x) or methotrexate (1x). In all 5 eyes with NVD
without retinal capillary drop out this treatment alone without additional
retinal laser photocoagulation resulted in regression of neovascularization.
Conclusions: Intensive immunosuppressive treatment in occlusive
retinal vasculitis is able to control optic disc neovascularization. Reduction
in local inflammatory and angiogenic factors by immunosuppressive treatment
might be responsible for regression of NVD.