Acute idiopathic blind spot enlargement syndrome (AIBSES) with retinal vasculitis.

AIBSES Blind spot Blind spot enlargement Retinal vasculitis

Journal

American journal of ophthalmology case reports
ISSN: 2451-9936
Titre abrégé: Am J Ophthalmol Case Rep
Pays: United States
ID NLM: 101679941

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 02 06 2022
revised: 05 11 2022
accepted: 19 11 2022
entrez: 23 12 2022
pubmed: 24 12 2022
medline: 24 12 2022
Statut: epublish

Résumé

To report the clinical and anatomical features of an unusual case of acute idiopathic blind spot enlargement syndrome (AIBSES) with retinal vasculitis. A 39-year-old patient, who was a known case of chronic headache with nonspecific visual symptoms for nine years, developed scotomas in her right eye. She was initially diagnosed with AIBSES which had been stable, but later worsened with symptoms of subsequent blind spot enlargement and photopsia on the left eye a year later. Increase in the size of the blind spot over the left eye and stability of the blind spot enlargement over the right eye was documented on Humphrey visual field (HVF) testing. Due to the rapid onset and severity of symptoms, an inflammatory etiology was entertained and this prompted referral to our clinic. At initial presentation, fluorescein angiogram (FA) revealed moderate diffuse vasculitis and disc leakage in the left eye, which existed alongside the enlarged blind spot. Corticosteroid treatment was suggested and initiated. The patient was found to have a reduction in the size of her blind spot and a decrease in severity of retinal vasculitis a month later. Unfortunately, the patient was then lost to follow up and had stopped steroid treatment of her own accord. After nine months without treatment, the patient's blind spot increased to a larger size than her initial presentation, as documented on HVF, with recurrence of vasculitis in the left eye. This is an unusual case of AIBSES which presented with vasculitis and rapid progression and has responded to steroids. Though monocular AIBSES has been shown to later affect the contralateral eye, concurrent vasculitis with AIBSES has not previously been reported. Furthermore, the response to treatment with reduction in blind spot enlargement is unusual for AIBSES. These findings stress the need for regular monitoring in cases of AIBSES.

Identifiants

pubmed: 36561880
doi: 10.1016/j.ajoc.2022.101760
pii: S2451-9936(22)00506-0
pmc: PMC9763352
doi:

Types de publication

Case Reports

Langues

eng

Pagination

101760

Informations de copyright

© 2022 The Authors.

Déclaration de conflit d'intérêts

The authors declare that there are no conflicts of interest related to this article.

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Auteurs

Rhys Ishihara (R)

University of Texas Medical Branch, Department of Ophthalmology and Visual Sciences, Galveston, TX, USA.

Youan Khan (Y)

Byers Eye Institute, Stanford University, Palo Alto, CA, USA.

Muhammad Sohail Halim (MS)

Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Ocular Imaging Research and Reading Center (OIRRC), Sunnyvale, CA, USA.

Amir Akhavanrezayat (A)

Byers Eye Institute, Stanford University, Palo Alto, CA, USA.

Neil Onghanseng (N)

Byers Eye Institute, Stanford University, Palo Alto, CA, USA.

Marc Harris Levin (MH)

Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, CA, USA.

Quan Dong Nguyen (QD)

Byers Eye Institute, Stanford University, Palo Alto, CA, USA.

Classifications MeSH