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RETINAL VASCULITIS IN A PATIENT WITH HANSEN DISEASE
Shravan V Savant1,2, Sarkis H Soukiasian1,2, Richard F Spaide3
1Beth Israel Lahey Health- Lahey Clinic, Burlington Massachusetts.
Retinal Cases & Brief Reports
|March 6, 2024
Summary
Retinal vasculitis, a potentially blinding complication of Hansen disease (leprosy), may be more common than previously thought. This case highlights the importance of screening for antiphospholipid antibodies in patients with Hansen disease to detect this eye condition.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Rheumatology
Background:
- Hansen disease (leprosy) is a global health concern, endemic in over 140 countries.
- It is a potentially blinding condition, with ocular manifestations requiring careful management.
Purpose of the Study:
- To describe a case of retinal vasculitis in a patient with Hansen disease.
- To investigate the association between Hansen disease, retinal vasculitis, and antiphospholipid antibodies.
Main Methods:
- A 37-year-old male patient with Hansen disease on standard therapy underwent a comprehensive ophthalmic evaluation.
- Diagnostic tools included dilated fundus examination and fluorescein angiography.
- Laboratory tests included antiphospholipid antibody serology and complete blood count.
Main Results:
- The patient presented with diffuse peripheral intraretinal hemorrhages and signs of retinal vasculitis in both eyes.
- Fluorescein angiography confirmed peripheral retinal nonperfusion, abnormal vascular shunting, and leakage.
- Laboratory results revealed positive antiphospholipid antibodies (lupus anticoagulant, anticardiolipin IgM, anti-beta-2 glycoprotein 1 IgM) and normocytic anemia.
Conclusions:
- Positive antiphospholipid antibodies are common in Hansen disease patients, suggesting retinal vasculitis may be underdiagnosed.
- Anterior segment scarring in Hansen disease can hinder retinal evaluation, potentially masking vascular complications.
- Increased surveillance for retinal vascular complications in Hansen disease patients is recommended.
