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Retinal Cases and Brief Reports

SCLEROMYXEDEMA WITH RETINAL VASCULITIS AND MACULAR EDEMA.

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Karen I Gutiérrez-Aguirre
Michael W Stewart
Jason C Sluzevich

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Abstrè

OBJECTIVE

To describe the findings and clinical course of a patient with scleromyxedema complicated by retinal vasculitis and macular edema.

METHODS

Interventional case report.

RESULTS

A 64-year old Caucasian woman with recently diagnosed, biopsy proven scleromyxedema presented with decreased visual acuity (20/50 OD; 20/100 OS) due to retinal vasculitis and macular edema. She received intravitreal bevacizumab and subtenon's triamcinolone acetonide for the macular edema, and bilateral pars plana vitrectomies were required for vitreous hemorrhages. Monthly intravenous infusions of immunoglobulins (IVIG) resulted in resolution of the macular edema and vasculitis, and stabilization of the VA (20/40 OD; counting fingers at 6 feet OS).

CONCLUSIONS

Scleromyxedema may be complicated by retinal vasculitis and macular edema. Treatment with corticosteroids and vascular endothelial growth factor inhibitors may be minimally effective but IVIG should be considered for both the ocular and systemic findings.

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