Leber´s Miliary Aneurysms - Case-report

Overview

The disease is classified along with idiopathic iuxtapapillary retinal teleangiectasisand Coat´s disease in the group of retinal teleangiectases.The disease was first described by Leber in l912. Sometimes the disease isconsidered an early form of Coat´s disease.The condition is usually unilateral, only rarely bilateral. Aneurysms are mostfrequently ina temporal position, in themedium to remote periphery of the retina.On examination by fluorescein angiography they reveal leakage. The disease hasa very slow progression and is usually diagnosed in advanced age.Leber´s miliary aneurysms are very frequently surrounded by hard whitishexsudates. They can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal haemorrhagesandmacular changes.Their size is greater than in diabetic retinopathy. Some aneurysms may be thrombotized. In someinstances exsudative detachment of the retina was described.Treatment is based on laser photocoagulation. Laser scars should not be veryintense to avoid damage of Bruch´s membrane and development of neovascularizationsand proliferations. Cryotherapy is indicated when the aneurysms are inthe periphery.The submitted case-report describes a patient with the bilateral form of Leber´smiliary aneurysms. On one eye the disease was complicated by the developmentof neovascularizations with repeated haemorrhage into the vitreous body.In thesubmittedpaper the authors describe the gradual progressionof the diseaseincl. the finding of fluorescein angiography and the selected therapeutic methodwhich contributed to stabilization of satisfactory visual functions.

Key words:
Leber´s miliary aneurysms, Coat´s disease, unilateral incidence,smallprogression, laser photocoagulation, cryotherapy, neovascularization, haemophthalmus,pars plana vitrectomy