Is There a True Neuroretinitis in Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome ?

Ocul Immunol Inflamm. 2022 May 19;30(4):845-847. doi: 10.1080/09273948.2020.1836234. Epub 2020 Dec 17.

Abstract

Purpose: To clarify whether a true neuroretinitis is part of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome.

Methods: Critical literature review.

Results: Neuroretinitis has been considered as a prominent feature of IRVAN syndrome. It has been described as late diffuse optic disc staining on fluorescein angiography. However, patients with IRVAN syndrome usually do not present with visual function alterations consistent with optic neuropathy or neuroretinitis. The typical stellate exudative maculopathy seen in IRVAN syndrome is primarily caused by leakage from retinal arteriolar aneurysms at or near the optic disc, and it could be misinterpreted as a feature of neuroretinitis.

Conclusion: There is no clinical evidence of true neuroretinitis at any of the disease stages in patients with IRVAN syndrome. The acronym « IRVARE » (Idiopathic Retinal Vasculitis, Aneurysms, and Retinal Exudates) is proposed to better characterize this syndrome.

Keywords: Idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome; arterial aneurysms; fluorescein angiography; neuroretinitis; retinal exudates.

Publication types

  • Review

MeSH terms

  • Aneurysm* / complications
  • Aneurysm* / diagnosis
  • Chorioretinitis* / complications
  • Dementia
  • Fluorescein Angiography
  • Hearing Loss, Central
  • Humans
  • Optic Atrophy
  • Retinal Vasculitis* / complications
  • Retinal Vasculitis* / diagnosis
  • Retinal Vasculitis* / drug therapy
  • Retinal Vessels
  • Retinitis* / diagnosis
  • Retinitis* / drug therapy
  • Syndrome

Supplementary concepts

  • Jensen syndrome