PRESENTING AUTHOR

Description of a case of peripheral retinal neovascularization (PRNV) with an undetermined cause in a young adult

A 41-year-old male presented with a one-month history of decreased vision and floaters in right eye (OD). Medical history included diabetes, hypertension, chronic kidney disease and morbid obesity. Ophthalmological examination revealed BCVA of 20/70 in right eye (OD) and 20/25 in left eye (OS). Anterior segment was unremarkable. In the posterior segment of the right eye, there was vitreous hemorrhage, dot and flame-shaped intraretinal and preretinal hemorrhages, and fibrovascular proliferations in the periphery. OD FA showed peripheral vascular closures, leakage from peripherial neovascularization and arteriovenous shunts. OS showed peripheral vascular closures.
Workup studies for infectious and autoimmune tests were negative, as well as tests for homocystinuria and hemoglobin electrophoresis. The patient was diagnosed with severe OSA (obstructive sleep apnea), with an apnea-hypopnea index (AHI) of 54.7%.

To date, possible causes of PRNV have been described, all of which were examined for this patient, without finding a clear explanation. Atypical findings in this case suggest diabetic retinopathy alone cannot explain the development of PRNV.

Recently, different articles have been published suggesting a possible association between OSA and PRVN. However, there is not yet sufficient evidence in the literature to support this hypothesis. Thus OSA could be an alternative cause of neovascularization in this patients case.