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Lee K, Jung S, Chin HS. Frosted Branch Angiitis; Case Series and Literature Review. Ocul Immunol Inflamm 2024; 32:31-39. [PMID: 36441990 DOI: 10.1080/09273948.2022.2148112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Frosted branch angiitis (FBA) is a rare form of retinal vasculitis. Four case series and an extensive literature review of 236 cases were conducted to clarify the characteristics of this rare condition. METHODS Case series and literature review. RESULTS An analysis of the reported cases revealed that a majority (54.6%) developed FBA in the presence of an underlying disease, with recurrence and complications requiring surgical intervention being rare. The frequency of bilateral occurrence (55.0%) and prevalence in female patients (45.0%) were noted to be lower than previously reported. CONCLUSION In general, idiopathic FBAs are more likely to be bilateral and diagnosed at a younger age than secondary FBAs. In idiopathic FBA, fundus involvement is more generalized, exudates tend to be more translucent, and extensive retinal hemorrhage tends to be less frequent. However, there were no differential characteristic fundus features that clearly distinguished idiopathic FBA from secondary FBA.
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Affiliation(s)
- Kanghoon Lee
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Soyeon Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hee Seung Chin
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Republic of Korea
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Mansour HA, Ozdal PÇ, Kadayifcilar S, Tugal-Tutkun I, Eser-Ozturk H, Yalçındağ FN, Petrushkin H, Chan EW, Belfaiza S, Karadag R, Güngör SG, Parodi MB, Mansour AM. Familial Mediterranean fever associated frosted branch angiitis, retinal vasculitis and vascular occlusion. Eye (Lond) 2022; 36:2157-2162. [PMID: 34725467 PMCID: PMC9581995 DOI: 10.1038/s41433-021-01822-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/27/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To analyse the entity of retinal vasculitis, including frosted branch angiitis (FBA), or retina vascular occlusion in patients with familial Mediterranean fever (FMF). METHODS Retrospective collaborative case series using invitation by email to uveitis specialists around the Mediterranean basin. This series was combined with a literature review. Exclusion criteria included infectious diseases, Behçet's disease or other autoimmune diseases. RESULTS A total of 16 patients (21 eyes) had FMF and retinal vasculitis (FBA 11 patients, mild retinal vasculitis 5 patients). The mean age at onset of vasculitis was 29.5 ± 13.4 (range 9-62) with a female to male ratio of 9 to 7. In 19 eyes treated with various forms of corticosteroid and/or immunosuppression, the mean initial spectacle-corrected visual acuity improved from 6/194 to 6/10.5 at the last mean follow-up of 29.0 ± 34.9 months (p < 0.001). The most common FEVR mutations were M680I and M694V. In addition, retinal vascular occlusions included one case of central retinal artery occlusion and one case of branch retinal artery occlusion. CONCLUSION FBA and milder forms of retinal vasculitis are associated with FMF. Therapy involves an increase in colchicine dosage in early cases, a long period of oral corticosteroid, intravitreal dexamethasone implant or periocular corticosteroid in select cases, and combination therapy with systemic immunosuppression in severe cases. FMF needs to be included in the differential diagnosis of retinal vasculitis.
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Affiliation(s)
- Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Pinar Ç Ozdal
- Uveitis and Behçet Disease Service, University of Health Sciences, Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | | | | | - Hilal Eser-Ozturk
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
| | | | - Harry Petrushkin
- Uveitis and Scleritis Service, Moorfields Eye Hospital, London, UK
- Pediatric Uveitis Service, Great Ormond St Hospital, London, UK
| | - Errol W Chan
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Canada
- Department of Ophthalmology, National University Health System, Singapore, Thailand
| | - Soukaina Belfaiza
- Department of Ophthalmology, Mohammed V Military Hospital, Rabat, Morocco
| | - Remzi Karadag
- RK Eye, Aesthetic and Health Services, Kadikoy, Istanbul, Turkey
- Veni Vidi Eye Center, Caddebostan, Kadikoy, Istanbul, Turkey
| | | | | | - Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
- Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon.
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Vofo BN, Amer R. Outer Retina Rupture from Subretinal Blood with Spontaneous Sealing and Visual Recovery in Frosted Branch Angiitis from Familial Mediterranean Fever: A Case Report. Turk J Ophthalmol 2022; 52:286-290. [PMID: 36017544 PMCID: PMC9421930 DOI: 10.4274/tjo.galenos.2022.69337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Familial Mediterranean fever (FMF) is a rare autoinflammatory disorder. Ocular involvement is rare. The full spectrum and response to treatment is poorly understood. An 18-year-old girl previously diagnosed with FMF presented with sudden loss of vision in the left eye (LE). Best-corrected visual acuity (BCVA) in the LE was finger counting at 1.5 meters. Angiitis with mild “frosting,” hemi-central retinal vein occlusion (HCRVO), and acute outer retina rupture (ORR) were observed in the LE. Systemic steroids were initiated immediately. The ORR was sealed 2 weeks later while vision improved to 6/15 (near vision: J2) 5 months later. No recurrences were observed over 5 years of follow-up. We report a rare manifestation of frosted branch angiitis with concomitant HCRVO and ORR in a young patient with FMF. Closure of ORR was attained and vision recovered after treatment with high-dose steroids.
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