Bilateral idiopathic frosted branch angiitis in an older patient

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Han Nie Han Ch'ng
Fazliana Ismail
Kiet Phang Ling


Background: To report the oldest age to our best knowledge presentation of idiopathic frosted branch angiitis (FBA) in the Asian population and its characteristics.
Methods: Case Report
Results: This is a rare case of bilateral fulminant frosted branch angiitis at older age of presentation and prolonged course of visual recovery with poor visual outcome in one eye. 58-year-old Malaysian female patient, presented with sequential involvement of both eye, initially right eye panuveitis, frosted branch angiitis and subretinal fluid at macula area then the left eye. Bilateral vision was hand movement. The laboratory investigation including autoimmune disease, infectious disease and vitreous sample for viral and tuberculosis
PCR were negative. Patient was treated with systemic steroid for a total duration of 6 months. Intravenous Acyclovir was initiated followed by oral Acyclovir. Vitritis reduced, exudative retinal detachment and vasculitis resolved but vision remained poor. Her vision slowly regained after 3 months of treatment and at 6 months her best corrected visual acuity for right eye was 2/60 due to ischemic maculopathy and left eye was 6/9.
Conclusion: Older age groups may present with more severe anterior and posterior inflammation compared to a younger age group, therefore prolonged and timely corticosteroid treatment is crucial for good visual outcome.
Conflicts of interest: The authors report no conflicts of interest.


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