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More MS news articles for July 2003

Proliferative retinal vasculitis and multiple sclerosis: a case report

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12843896&dopt=Abstract

J Fr Ophtalmol. 2003 Apr;26(4):381-5
Patte M, Rouher FN, Vernay D, Delaire JC, Bacin F.
Service d'Ophtalmologie.

INTRODUCTION:

Retinal periphlebitis can precede the neurological effects of multiple sclerosis and reveal the disease.

Although these occurrences of vasculitis are noted in 10% - 35% of multiple sclerosis patients, proliferative retinopathy is, on the contrary, an exceptional complication.

CASE REPORT:

We report the case of a 28-year-old woman who presented bilateral, proliferative, retinal vasculitis complicated with recurrent vitreous hemorrhages occurring with multiple sclerosis.

Initially, there was a unilateral, central venous thrombosis in a particularly ischemic and proliferative form.

After a neurological, biological and radiological check-up, the diagnosis of multiple sclerosis was pronounced and treatment with Interferon was started.

A pan-retinal laser photocoagulation and vitrectomy with proliferative membrane peeling were performed.

After a follow-up of 2.5 years, a bilateral epiretinal membrane on the macula with a chronic macular edema persisted, with visual acuity limited to 0.2 Parinaud 4 in the right eye and 0.5 Parinaud 2 in the left eye.

DISCUSSION:

This case shows that the diagnosis of multiple sclerosis must be established in cases of ischemic retinal vasculitis, especially as the literature does not seem to report a correlation between the retinal vascular affect and how far multiple sclerosis has progressed.

Moreover, the visual prognosis of these proliferative lesions remains uncertain.

CONCLUSION:

Multiple sclerosis can be revealed initially, although exceptionally, by bilateral, proliferative and severe retinal vasculitis complicated with recurrent vitreous hemorrhages and tractional retinal detachment.