Postoperative cilioretinal artery occlusion in Sturge Weber-associated glaucoma

Progressive retinal vessel malformation in a premature infant with Sturge-Weber syndrome: a case report and a literature review of ocular manifestations in Sturge-Weber syndrome

BACKGROUND

Sturge-Weber syndrome is a disorder marked by a distinctive facial capillary malformation, neurological abnormalities, and ocular abnormalities such as glaucoma and choroidal hemangioma.

CASE PRESENTATION

We report a case of progressively formed retinal vessel malformation in a premature male infant with Sturge-Weber syndrome and retinopathy of prematurity, after treatment with intravitreal anti-vascular endothelial growth factor (VEGF). The baby was born at 30 weeks gestation with a nevus flammeus involving his left eyelids and maxillary area. On postmenstrual age week 39, he received intravitreal anti-VEGF. Diffuse choroidal hemangioma became evident at 40 weeks, with the classic "tomato catsup fundus" appearance. These clinical findings characterized Sturge-weber syndrome. He presented with posterior retinal vessel tortuosity and vein-to-vein anastomoses at 44 weeks.

CONCLUSION

This is a rare case of documented progression of retinal vessel malformations in a patient with Sturge-Weber syndrome and retinopathy of prematurity.

Combined cilioretinal artery and hemi-retinal vein occlusion in Sturge Weber syndrome: Expanding the clinical spectrum

A 9-year-old boy with the diagnosis of Sturge-Weber Syndrome, and port-wine stain involving the right side of the face, presented with acute visual loss of the right eye. Examination revealed a high intraocular pressure and a combined cilioretinal artery and inferior hemi-retinal vein occlusion in the right eye. Systemic work-up was negative. After controlling the intraocular pressure, gradual improvement of vision was noticed with simultaneous disappearance of signs of vascular occlusion.

Sturge-Weber Syndrome (Encephalotrigeminal Angiomatosis): Recent Advances and Future Challenges

Sturge-Weber syndrome (SWS) is a congenital, sporadically occurring, neurocutaneous syndrome that presents classically with port-wine stain, leptomeningeal angiomas, and glaucoma. The systemic implications of SWS are vast and involve not only ophthalmic manifestations but also dermatologic, neurologic, and oral manifestations. Neuroimaging, in particular, plays an important role in the diagnosis and management of this disease. Recent discoveries have been made regarding the genetic pathogenesis of SWS. In addition, recent advances have been made in the management of the 2 most common ophthalmic manifestations of SWS: diffuse choroidal hemangioma and glaucoma. Despite these new contributions to the field, many challenges still remain. The management of diffuse choroidal hemangioma is wide ranging and includes photodynamic therapy, brachytherapy, radiotherapy, and antivascular endothelial growth factor injections, but all have had limited or varied success. Although there have been recent advances in knowledge and technique, the management of glaucoma is extremely complex, given the high surgical risks for complications and a poor response rate to medical therapy. Further studies are critical to maximize our knowledge of this difficult disease.

Incidence of cilioretinal arteries in Chinese Han population

AIM

To estimate the incidence of cilioretinal arteries among Han population of north China.

METHODS

A cross-sectional sample of subjects aged from 20 years old to 80 years old were selected using a cluster sampling technique from Shenyang of Liaoning Province for Diabetic Eye Disease Study. Eligible subjects were recruited in the Community Health Center which took the stereo fundus photography using 45°Non-Mydriatic Fundus Camera. Data were analyzed by SPSS 14.0.

RESULTS

The incidence of cilioretinal arteries in 5000 eyes of 2500 subjects was determined. One, two or more cilioretinal arteries were present in 876 of all subjects and in 923 of all the eyes. Difference of presence, number and distribution of cilioretinal arteries was observed. During the subjects, the arteries occurred bilaterally in 6.9% and contributed to some portion of the temporal circulation in 78.3%, nasal circulation 14.8%, respectively. Statistical analysis indicated that there was no significant difference in incidence between men and women, left and right eyes (P>0.05).

CONCLUSION

35.0% persons have the cilioretinal arteries in Han population of north China. Men and women have an equal distribution of cilioretinal arteries.