Archives of Ophthalmology and Eye Disorders (AOED)
Vol. 3, Issue 1, 2022, pp. 1-2

Occlusive Retinal Vasculitis With Neovascularization Associated With Multiple Sclerosis

Louis Vaudoisey0, Majda Rachdi0, Mathieu Baransk0, Maria Khalil0, Dorine Makhoul0, Aurélie Le0

DOI: | Published: 2022-08-22 | Article page and PDF

Abstract

A 25-year-old woman went to the eye casualty as an emergency for bilateral blurred vision. Slit lamp examination revealed bilateral

granulomatous panuveitis, with cyclitic membrane in the anterior chamber and intense cataract. Spectral-domain optical coherence

tomography (SD-OCT) presented bilateral serous retinal detach- ment and numerous cells in the vitreous. (Figure 1). Blood samples, thorax scanner and a cerebral magnetic resonance imaging (MRI) were prescribed to find a possible etiology. Oph- thalmoscopy and intravenous fluorescein angiography revealed vitritis, papillitis, occlusive retinal vasculitis on both eyes and an inactive neovessel in a large ischemic area

Keywords:

Louis Vaudoisey*, Majda Rachdi, Mathieu Baranski, Maria Khalil, Dorine Makhoul and Aurélie Le.

*Address for Correspondence: Louis Vaudoisey, CHU Saint-Pierre, 105 rue aux laines 1000 Bruxelles, Belgium; E-mail: louisvaudoisey@ Received: 04 August 2022; Accepted: 19 August 2022; Published: 22 August 2022 Citation of this article: Vaudoisey, L., Rachdi, M., Baranski, M., Khalil, M., Makhoul, D., Le, A. (2022) Occlusive Retinal Vasculitis With Neovascularization Associated With Multiple Sclerosis. Arch Ophthalmol Eye Disord, 3(1): 01-02.

Copyright: © 2022 Louis Vaudoisey, et al. This is an open access articwle distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ophtalmology, CHU Saint-Pierre, Brussels, Belgium hotmail.com

Clinical Image

inactive neovessel in a large ischemic area (Figure 2 A, B).

Meanwhile, MRI was performed and revealed white matter lesions (Figure 3). Neurology testings including physical examination and lumbar puncture confirmed multiple sclerosis (MS) diagnosis.

MS is an autoimmune disease. Classically, demyelinating white matter lesions can be found in the brain or spinal cord [1]. It can © 2022 Somato Publications. All rights reserved.

be associated with different ophthalmic manifestations like optic neuritis, ocular motor abnormalities and uveitis [2]. Uveitis can be the first clinical sign leading to the diagnosis of MS [3].

Retinal vascular sheathing, vitreous debris, granulomatous anterior uveitis and synechiae are classical ocular findings described in panuveitis associated with multiple sclerosis [4].

Occlusive retinal vasculitis associated with neovascularization, as shown in our case, is another rare entity which has been described. It can appear when there is severe periphlebitis leading to ischemia and neovascularization of the retina [5]. This clinical finding should also lead to a work up searching for a MS, including MRI to exclude white matter lesions.

Funding

None

Conflicts of interest/Competing interests

There are no conflicts of interest 01 Volume 3 Issue 1 - 1006

Figure 1: OCT showing retinal serous detachment and numerous cells in the vitreous. OCT, optical coherence tomography
Figure 1: OCT showing retinal serous detachment and numerous cells in the vitreous. OCT, optical coherence tomography
Figure 2: (A) Color fundus photography showing vitritis in the left eye. (B) Fluorescein angiography showing vasculitis and inactive neovessel (arrow).
Figure 2: (A) Color fundus photography showing vitritis in the left eye. (B) Fluorescein angiography showing vasculitis and inactive neovessel (arrow).
Figure 3: White matter lesions (arrows) detected with MRI.
Figure 3: White matter lesions (arrows) detected with MRI.

Archives of Ophthalmology and Eye Disorders © 2022 Somato Publications. All rights reserved.

References

  1. McDonald, WI., Compston, A., Edan, G., Goodkin, D., Hartung, HP., Paty, DW., et al. (2001) Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol, 50(1):121-127.
  2. AlBloushi, AF., Dheyab, AM., Al-Swaina, NF., Al-Obailan, M., Daif, AK., Abu El-Asrar, AM. (2021) Clinical findings and outcomes of uveitis associated with multiple sclerosis. Eur J Ophthalmol, 31(2):482-490.
  3. Olsen, TG., Frederiksen, J. (2017) The association between multiple sclerosis and uveitis. Surv Ophthalmol, 62(1):89-95.
  4. Cunningham, ET Jr., Pavesio, CE., Goldstein, DA., Forooghian, F., Zierhut, M. (2017) Multiple Sclerosis-Associated Uveitis. Ocul Immunol Inflamm, 25(3):299-301.
  5. Vine, AK. (1992) Severe periphlebitis, peripheral retinal ischemia, and preretinal neovascularization in patients with multiple sclerosis. Am J Ophthalmol, 113(1):28-32. Volume 3 Issue 1 - 1006