Case Of Frosted Branch Angiitis Research Articles

Frosted Branch Angiitis Associated with COVID-19-related Multisystem Inflammatory Syndrome in Children

Purpose: To report a case of frosted branch angiitis associated with COVID-19-related multisystem inflammatory syndrome in children (MIS-C).Case summary: An 8-year-old boy was referred to the ophthalmology clinic with decreased visual acuity in his right eye. The initial best-corrected visual acuity (BCVA) was 20/63 in the right eye and 20/32 in the left eye. Upon fundus examination, bilateral frosted branch-like vascular sheathing and retinal hemorrhage were observed. Optical coherence tomography (OCT) demonstrated macular edema. Fluorescein angiography revealed late staining and leakage of affected retinal vessels. The patient exhibited persistent fever, rash, and gastrointestinal symptoms, accompanied by an increase in inflammatory markers in laboratory tests. Testing for SARS-CoV-2 immunoglobulin G (IgG) was positive, although there was no evidence of any other autoimmune diseases or viral infections. The patient was diagnosed with frosted branch angiitis associated with MIS-C. Treatment included systemic steroids and 1% prednisolone eye drops. After 2 weeks, the BCVA improved to 20/20 in both eyes, and all clinical signs resolved without recurrence.Conclusions: In patients with frosted branch angiitis without any other apparent cause, the possibility of MIS-C should be considered. Testing for COVID-19 infection is recommended.

Frosted branch angiitis and cerebral venous sinus thrombosis as an initial onset of neuro-Beh\xe7et\u2019s disease: a case report and review of the literature

BackgroundFrosted branch angiitis is a rare, severe condition. It can be either a primary or a secondary condition and is characterized by rapid deterioration of vision and fulminant retinal vasculitis that manifests as diffuse sheathing of retinal vessels, macular edema, papillitis, vitritis and anterior uveitis. We aimed to describe a case of frosted branch angiitis and cerebral venous sinus thrombosis as an initial neuro-Behçet’s disease onset. Diagnosis of Behçet’s disease was based on the current 2014 International Criteria for Behçet’s Disease and the International consensus recommendation criteria for neuro-Behçet’s disease. In addition, a literature review using search parameters of “frosted branch angiitis”, “Behçet” and “neuro-Behçet” in the PubMed database is presented.Case presentationA 28-year-old Brazilian pardo woman presented to our hospital with abrupt bilateral vision loss associated with recurrent aphthous oral ulcers 6 months before visual symptom onset. A fundus examination showed bilateral widespread retinal vasculitis with venous and arterial white sheathing, optic disc swelling, macular edema, and retinal hemorrhages, leading to the diagnosis of frosted branch angiitis. An extensive systemic workup for retinal vasculitis was uneventful, except for brain magnetic resonance imaging demonstrating cerebral venous sinus thrombosis and lymphocytic aseptic meningitis. A diagnosis of neuro-Behçet’s disease was made, and treatment was started with methylprednisolone therapy 1 g/day for 5 consecutive days, followed by oral mycophenolate mofetil and infliximab 5 mg/kg infusion. The patient’s response was rapid, with improvement of visual acuity to hand movement and counting fingers by day 7 and final visual acuity of counting fingers and 20/130.ConclusionsFrosted branch angiitis may be associated with infectious, noninfectious, or idiopathic causes. An extensive workup should be done to exclude systemic vasculitis such as Behçet’s disease. Treatment with systemic steroids must be promptly initiated in association with specific treatment aimed at inflammation control and blindness risk reduction.

Frosted branch angiitis in an AIDS patient with cytomegalovirus retinitis

A case of frosted branch angiitis in an AIDS patient with cytomegalovirus (CMV) retinitis is reported. The use of PCR techniques for CMV DNA detection in intraocular fluid was helpful in this situation. The appropriate therapy was given promptly due to the timely diagnosis based on this assay.

Bilateral frosted branch angiitis as the presenting sign of antiphospholipid antibody syndrome.

Background“Frosted branch retinal angiitis” is an encompassing term for a rare, typically bilateral diffuse retinal periphlebitis that may occur in a number of varying conditions. To our knowledge, we report the first case of frosted branch angiitis as the presenting sign of antiphospholipid antibody syndrome in a 28-year-old woman.FindingsThis study is a retrospective case report and literature review. Serial fundus photos, fluorescein angiogram, and ocular coherence tomography taken were before and after treatment, showing resolution of diffuse retinal perivascular sheathing and macular edema along with marked improvement in visual acuity 4 months after the treatment with corticosteroids.ConclusionsFrosted branch angiitis can be seen in association with antiphospholipid antibody syndrome. Prompt recognition and treatment with corticosteroids may result in good visual prognosis, and long-term immunosuppression and additional anticoagulation may be beneficial to prevent recurrence.

A case of frosted branch angiitis in an immunocompromised child

Frosted branch angiitis is a rare vascular reaction believed to be a nonspecific immune response to an infective, neoplastic, or idiopathic insult. The clinical presentation is characteristic and typically affects children and younger adults, and the prognosis is good. We report a case of frosted branch angiitis during immune recovery in a 2-year-old boy with Langerhans cell histiocytosis on systemic immunosuppressive therapy.

Acute idiopathic frosted branch angiitis in an 11-month-old infant treated with intravitreal triamcinolone acetonide

An 11-month-old boy presented with bilateral vision loss following upper respiratory tract infection. Extensive perivascular sheathing resembling frosted branch angiitis and severe macular edema was noted in both eyes. All tests for etiological diagnosis were negative. Treatment with systemic corticosteroids and antibiotics caused resolution of perivascular infiltrates. Macular edema resolved with improvement in visual acuity following consecutive bilateral intravitreal triamcinolone acetonide injections. To our knowledge, this is the youngest reported case of frosted branch angiitis.

Bilateral acute idiopathic frosted branch angiitis in a pregnant woman.

To present a case of frosted branch angiitis in a pregnant woman. A 27-week pregnant 18-year-old woman was presented with bilateral decreased visual acuity. Fundoscopy showed typical appearance of frosted branch angiitis. A good spontaneous clinical improvement was observed during systemic evaluation. No treatment was started. Frosted branch angiitis may be seen during pregnancy, without any associated underlying disease, and can be resolved without any intervention. The treatment may not be necessary for some cases.

Frosted Branch Angiitis, Presumably Related to Dermatomyositis

Purpose: To report the first case of frosted branch angiitis associated with dermatomyositis in a Korean woman.Methods: Case report.Results: A 42-year-old woman with history of dermatomyositits presented with unilateral decreased visual acuity. Fundus examination showed findings consistent with frosted branch angiits. After 1 month of oral prednisolone, the patient made significant visual recovery with near complete resolution of vascular sheathing.Conclusions: To the best of the authors’ knowledge, this is the first case of frosted branch angiitis associated with dermatomyositis. Dermatomyositis should be considered in the differential diagnosis of patients presenting with frosted branch angiitis.

Frosted Branch Angiitis Secondary to Macular Choroidal Neovascularization in a Chinese Woman

This is perhaps the first report of frosted branch angiitis secondary to choroidal neovascularization (CNV) from China. We describe a case of frosted branch angiitis associated with macular CNV. A 19-year-old Chinese woman complained of metamorphopsia and blurred vision in the right eye on August 27, 2002. Fluorescein angiography demonstrated CNV in the macula. Five months later, focal and atrophic choroidal scars were observed in the macular area. She complained of blurred vision again on April 14, 2003. Iridocyclitis and frosted branch angiitis were found in both fundi. Following treatment with systemic acycloguanosine and corticosteroids for 4 months, the fundi recovered almost completely. A case of frosted branch angiitis secondary to macular choroidal neovascularization is reported in a Chinese woman. The relation between frosted branch angiitis and CNV remains to be further explored.

A Case of Frosted Branch Angiitis With Yellowish-White Placoid Lesions: Fluorescein and Indocyanine Green Angiography Findings

Severe, white sheathing of the retinal vessels and yellowish-white placoid lesions, suggesting frosted-branch angiitis, were found in both fundi of a 24-year-old woman. Fluorescein angiography showed hypofluorescence of the placoid lesions in the early phase and hyperfluorescence in the late phase. Indocyanine green angiography showed hypofluorescence during all phases. These findings imply an occlusion of the choriocapillaris. Fluorescein angiography also showed occlusion of the peripheral retinal vessels. With systemic corticosteroids and prostaglandin I 2 derivative, the fundi recovered almost completely to normal 3 months later.