Summary:
The disease is classified along with idiopathic iuxtapapillary retinal teleangiectasis
and Coat´s disease in the group of retinal teleangiectases.
The disease was first described by Leber in l912. Sometimes the disease is
considered an early form of Coat´s disease.
The condition is usually unilateral, only rarely bilateral. Aneurysms are most
frequently ina temporal position, in themedium to remote periphery of the retina.
On examination by fluorescein angiography they reveal leakage. The disease has
a very slow progression and is usually diagnosed in advanced age.
Leber´s miliary aneurysms are very frequently surrounded by hard whitish
exsudates. 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 some
instances exsudative detachment of the retina was described.
Treatment is based on laser photocoagulation. Laser scars should not be very
intense to avoid damage of Bruch´s membrane and development of neovascularizations
and proliferations. Cryotherapy is indicated when the aneurysms are in
the periphery.
The submitted case-report describes a patient with the bilateral form of Leber´s
miliary aneurysms. On one eye the disease was complicated by the development
of neovascularizations with repeated haemorrhage into the vitreous body.
In thesubmittedpaper the authors describe the gradual progressionof the disease
incl. the finding of fluorescein angiography and the selected therapeutic method
which contributed to stabilization of satisfactory visual functions.
Key words:
Leber´s miliary aneurysms, Coat´s disease, unilateral incidence,small
progression, laser photocoagulation, cryotherapy, neovascularization, haemophthalmus,
pars plana vitrectomy
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