An Unusual Retinal Vessel Modification in Patients Affected by JIA-Uveitis with a Follow-Up Longer Than 16 Years

الملخص EN

Purpose.

To report unusual and rare clinical changes of retinal vessel pattern in a series of patients affected by Juvenile Idiopathic Arthritis (JIA) uveitis with a follow-up longer than 16 years.

Methods.

A series of three patients with JIA-uveitis followed at the University of Rome “Sapienza” from 1998 to 2014 were reported.

The retinal vessels were analyzed with fluorescein angiography using Heidelberg Retinal Angiogram-2 (HRA-2; Heidelberg Engineering GmBH, Dossenheim, Germany) and the Topcon TRC-50LX retinal camera (Topcon Europe, The Netherlands).

A Spectralis Domain OCT (SD-OCT) (Spectralis Family Heidelberg, Germany) was performed to evaluate vessel anatomy.

Results.

Fundus photography showed sheathed vessels localized around the optic disc in every case.

Angiography revealed a normal physiology of vessel walls and flow; no sheathing or leakage of dye was observed.

SD-OCT demonstrated reflective vessel walls.

Vessel lumen appeared patent, and the normal “hourglass configuration” was blurred, but identifiable.

Conclusions.

Vessel modifications observed in long-standing JIA-uveitis are not signs of vascular inflammation and are not associated to hypoperfusion.

In these cases, ophthalmologists should avoid further invasive investigation and should consider introducing SD-OCT as a routine method to evaluate the vessel changes during the follow-up.