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Retinal Vasculitis in a Patient With Isaacs Syndrome and Inclusion Body Myositis
Luis Martinez-Velazquez1, Paul Zhou1, Francisco J López-Font2
1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Journal of Vitreoretinal Diseases
|April 3, 2023
Summary
This case study details a patient with rare autoimmune disorders who developed bilateral occlusive retinal vasculitis. Treatment with laser photocoagulation and intravitreal bevacizumab stabilized vision, suggesting autoimmunity as a cause.
Area of Science:
- Ophthalmology
- Rheumatology
- Neurology
Background:
- Autoimmune disorders, such as Isaacs syndrome and inclusion body myositis (IBM), can present with complex systemic manifestations.
- Retinal vasculitis is an inflammatory condition affecting the blood vessels of the retina, potentially leading to vision loss.
Observation:
- A 55-year-old woman with a history of Isaacs syndrome and IBM presented with a 3-month history of decreased vision.
- Ophthalmic examination revealed peripheral intraretinal hemorrhages, subhyaloid hemorrhage, and preretinal fibrosis.
- Fluorescein angiography demonstrated peripheral leakage and capillary nonperfusion in both eyes, indicative of occlusive vasculitis.
Findings:
- The patient's presentation was consistent with bilateral occlusive retinal vasculitis.
- Treatment involved scatter laser to nonperfused retinal areas and intravitreal bevacizumab.
- Vision stabilized at 20/15 in both eyes within four months, with resolution of peripheral leakage.
Implications:
- This case highlights a potential link between rare autoimmune neuromuscular disorders and retinal vasculitis.
- Autoimmunity, possibly related to antiphospholipid syndrome antibodies, is implicated as the underlying mechanism.
- Prompt diagnosis and multimodal treatment, including anti-VEGF therapy, can effectively manage vision-threatening retinal vasculitis in autoimmune patients.
