| Presentation preference | Poster presentation |
| Title | Long-Term Management of IRVAN: A Clinical Challenge |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To characterize long-term management of IRVAN (Retinal Vasculitis, Aneurysms, and Neuroretinitis Idiopathic Retinal Vasculitis). |
| Methods | Retrospective chart review of clinical/laboratorial data/multimodal imaging. |
| Results | Three females, aged12-33 years, presented with bilateral disease, two with acute/recent changes consisting of multiple arteriolar aneurysms(AA), optic disc swelling(ODS), lipid exsudation(LE) and extensive peripheral vascular sheathing/oclussion(PVSO), consistent with IRVAN. The other younger one had chronic/longstanding changes, inclusing bilateral foveal scarring, diffuse lipid exudation and PSVO, with a history of “Coat’s disease”, treated elsewhere with laser/anti-VEGF. BCVA at presentation ranged from 20/20 to 20/160. All cases were aggressively treated with corticosteroid therapy, immunomodulation, laser photocoagulation, and the two older ones also with anti-VEGF. Intraocular inflammation was subsequently controlled, with stabilization or improvement of VA in all cases to a range of 20/20 to 20/70, with a follow-up of 38-148 months. Curiously, the younger patient initially presenting with chronic changes developed recrudescence (onset of AA, increased LE and ODS), after 7 years of my immunomodulation with methotrexate. Adalimumab was added, with a course of PO steroids, further leading to control of the condition over the following 5 years of follow-up. |
| Conclusion | IRVAN represents a rare and chronic potentially vision-threatening condition requiring early diagnosis and treatment. Multimodal imaging is critical for accurate diagnosis/monitoring. Aggressive long-term management with steroids, immunomodulation, laser and anti-VEGF can effectively stabilize disease and prevent vision loss, improving long-term outcomes. |
| Conflict of interest | No |
1
| Last name | MACHADO |
| Initials of first name(s) | D.O |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
2
| Last name | Andrade |
| Initials of first name(s) | A.C |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), |
| City | Belo Horizonte |
| Country | Brazil |
3
| Last name | Rocha |
| Initials of first name(s) | AC.H |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
4
| Last name | Beneti |
| Initials of first name(s) | G.C |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG), |
| City | Belo Horizonte |
| Country | Brazil |
5
| Last name | Lara |
| Initials of first name(s) | C.M |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG) |
| City | Belo Horizonte |
| Country | Brazil |
6
| Last name | Vasconcelos-Santos |
| Initials of first name(s) | D.V |
| Department | Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG |
| City | Belo Horizonte |
| Country | Brazil |
