[Conservative therapy of isolated retinal vasculitis]

Area of Science:

• Ophthalmology
• Vascular Medicine
• Immunology

Background:

• Isolated retinal vasculitis (IRV) presents a therapeutic challenge, characterized by inflammation solely within retinal blood vessels.
• Effective management strategies for IRV are crucial to prevent vision loss.

Purpose of the Study:

• To evaluate the efficacy of different corticosteroid administration methods for treating isolated retinal vasculitis.
• To compare visual acuity improvement and exudate resorption rates among various treatment approaches.

Main Methods:

• Retrospective analysis of 43 IRV patients treated with corticosteroids via pulse therapy, oral administration, or periocular injections.
• Assessment of visual acuity changes and time to resorption of retinal perivascular exudate.
• Use of adjunctive therapies including cyclosporin A for steroid-resistant cases, fibrinolytics, angioprotectors, and antioxidants.

Main Results:

• Steroid pulse therapy demonstrated superior improvement in visual acuity (0.35 +/- 0.15) compared to oral (0.16 +/- 0.06) and periocular (0.06 +/- 0.12) treatments.
• Resorption of retinal perivascular exudate was significantly faster with steroid pulse therapy (8.1 +/- 2.2 days) versus oral (17.9 +/- 2.8 days) or periocular (30.9 +/- 7.1 days) administration.
• Prednisolone was used for maintenance therapy, and cyclosporin A was effective in steroid-resistant patients.

Conclusions:

• Corticosteroid pulse therapy is a highly effective treatment for isolated retinal vasculitis, offering faster visual recovery and exudate resolution.
• Different routes of corticosteroid administration yield varying clinical outcomes in IRV management.
• Comprehensive treatment including maintenance therapy and alternative agents like cyclosporin A is essential for managing IRV.