Maurice F. Rabb » Bilateral Retinal Vasculitis

The patient is a 47 year old white man with bilateral retinal vasculitis. He has a history of amblyopia in the right eye. In 1980 the patient experienced several episodes of Amaurosis fugax in both eyes. Noninvasive carotid studies were nefative at that time. The patient was asystomatic until April of 1985 at which time he noticed decreased vision in his left eye. He was noted to have evidence of a diffuse arteritic process in both eyes with arterial sheathing, cotton wool spots, retinal hemorrhages, and vitreous cells. A systemic evaluation produced evidence of a wide spread arteritic process including livido reticularis of the arms and legs, migratory lung infiltration on chest X-ray and aortic regurgitation. Laboratory investigation included a negative ANA, rheumatoid factor and cryoglobulins. The patient was found to have a circulating lupus anticoagulant and hypocomplementemia. The patient was subsequently started on prednisone, 60 mg per day.

On July 3 1985, the patient was noted to have peripupillary rubeosis and extensive angle neovascularization in the left eye. NVD nad NVE were also present in the left fundus. The patient therefore received 2600 spots of panretinal photocoagulation to the left eye. Angle neovascularization was subsequently noted in the right eye and the patient receivied 2100 spots of panretinal photocoagulation to that eye. Neovascularization in both eyes was noted to regress after this treatment.