Leberova miliární aneuryzmata (kazuistika)
| Title in English | Leber's miliary aneurysms (case report) |
|---|---|
| Authors | |
| Year of publication | 2003 |
| Type | Article in Periodical |
| Magazine / Source | Česká a Slovenská Oftalmologie |
| MU Faculty or unit | |
| Citation | |
| Field | ORL, ophthalmology, stomatology |
| Keywords | Leber's miliary aneurysms; Coat's disease; unilateral incidence; small progression; laser photocoagulation; cryotherapy; neovascularization; haemophthalmus; pars plana vitrectomy |
| Description | The disease is classified along with idiopathic iuxtapapillary retinal teleangiectasis and Coat's disease in the group of retinal teleangiectases. The disease was first described by Leber in 1912. Sometimes the disease is considered an early form of Coat's disease. The condition is usually unilateral, only rarely bilateral. Aneurysms are most frequently in a temporal position, in the medium to remote periphery of the retina. On examination by fluorescein angiography they reveal leakage. The disease has a very slow progression and is usually diagnosed in advanced age. Leber's miliary aneurysms are very frequently surrounded by hard whitish exsudates. They can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal haemorrhages and macular changes. Their size is greater than in diabetic retinopathy. Some aneurysms may be thrombotized. In some instances exsudative detachment of the retina was described. Treatment is based on laser photocoagulation. Laser scars should not be very intense to avoid damage of Bruch's membrane and development of neovascularizations and proliferations. Cryotherapy is indicated when the aneurysms are in the periphery. The submitted case-report describes a patient with the bilateral form of Leber's miliary aneurysms. On one eye the disease was complicated by the development of neovascularizations with repeated haemorrhage into the vitreous body. In the submitted paper the authors describe the gradual progression of the disease incl. the finding of fluorescein angiography and the selected therapeutic method which contributed to stabilization of satisfactory visual functions. |