A Case of Idiopathic Retinitis Vasculitis Aneurysms and Neuroretinitis (IRVAN) Treated with Adalimumab

ABSTRACT

Purpose

To report a case of IRVAN in a 13-year-old girl responding well to Adalimumab and Azathioprine.

Results

A 13-year-old girl presented to us with central scotoma for a duration of 10 months. She was treated earlier with oral steroids with poor response. Fundus examination revealed features of IRVAN. She was treated with intravitreal dexamethasone implant in both eyes with oral Mycophenolate Mofetil (MMF) with transient response to it. So she was switched over to subcutaneous Adalimumab 40 mg once in 2 weeks and oral Azathioprine 50 mg BD. The disease activity was well controlled with the current regime.

Conclusion

Though various treatment modalities have been described in literature for the treatment of IRVAN. This is the first case of IRVAN to be treated with Adalimumab along with Azathioprine to be reported.

KEYWORDS:

• Adalimumab
• Aneurysmal dilatation
• IRVAN
• Neuroretinitis
• Vasculitis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Summary

Idiopathic retinal vasculitis, Aneurysms and neuroretinitis (IRVAN) is a rare clinical entity of unknown etiology with no definitive guidelines for its medical management. We report a case of IRVAN with good response to fortnightly subcutaneous Adalimumab and daily oral Azathioprine with no systemic side effects on follow-up.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.