Periflebite retiniana na esclerose múltipla: relato de um caso

Monteiro, Mario Luiz R.; Callegaro, Dagoberto; Cunha-Souza, Eduardo; Scaff, Milberto

doi:10.1590/S0004-282X1985000400007

Resumos

Embainhamento venoso na periferia da retina é achado que ocorre em 10 a 20% dos pacientes com esclerose múltipla, podendo surgir em qualquer estágio da doença. Acredita-se que esta periflebite represente o correlato retiniano das lesões vasculares observadas no cérebro de pacientes com esclerose múltipla, mas a sua fisiopatogenia ainda é desconhecida. Neste registro é apresentado um caso em que se observou periflebite retiniana num quadro inicial de esclerose múltipla e é ressaltada a importância diagnóstica deste achado semiológico.

Sheathing of peripheral retinal veins occurs in 10 to 20% of patients with multiple sclerosis and can be seen at any point in the progression of the disease. This finding may represent the retinal correlate of the vascular lesions that are present in the central nervous system of patients with multiple sclerosis. Its pathogenesis is still uncertain. In this paper it is registered the occurrence of retinal periphlebitis as one of the initial manifestations of a patient with multiple sclerosis and it is discussed the diagnostic implications of this finding.

Periflebite retiniana na esclerose múltipla: relato de um caso

Retinal periphlebitis in multiple sclerosis: a case report

Mario Luiz R. Monteiro^I; Dagoberto Callegaro^II; Eduardo Cunha-Souza^III; Milberto Scaff^IV

^IMédico Assistente. Divisão de Oftalmologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

^IIMédico Assistente. Divisão de Neurologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

^IIIMédico Residente. Divisão de Oftalmologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

^IVProfessor Livre Docente. Divisão de Neurologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo

RESUMO

Embainhamento venoso na periferia da retina é achado que ocorre em 10 a 20% dos pacientes com esclerose múltipla, podendo surgir em qualquer estágio da doença. Acredita-se que esta periflebite represente o correlato retiniano das lesões vasculares observadas no cérebro de pacientes com esclerose múltipla, mas a sua fisiopatogenia ainda é desconhecida. Neste registro é apresentado um caso em que se observou periflebite retiniana num quadro inicial de esclerose múltipla e é ressaltada a importância diagnóstica deste achado semiológico.

SUMMARY

Sheathing of peripheral retinal veins occurs in 10 to 20% of patients with multiple sclerosis and can be seen at any point in the progression of the disease. This finding may represent the retinal correlate of the vascular lesions that are present in the central nervous system of patients with multiple sclerosis. Its pathogenesis is still uncertain. In this paper it is registered the occurrence of retinal periphlebitis as one of the initial manifestations of a patient with multiple sclerosis and it is discussed the diagnostic implications of this finding.

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Trabalho da Divisão de Oftalmologia e da Divisão de Neurologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo.

Clínica Oftalmológica, Hospital das Clínicas, FMUSP - Caixa Postal 8091 - 01000 -São Paulo, SP - Brasil.

1. ADAMS, C.W.M. - Pathology of multiple sclerosis: progression of the lesion. Brit. med. Bull. 33:15, 1977.
2. ARCHAMBEAU, P.L.; HOLLENHORST, R.W. & RUKER, C.W. - Posterior uveitis as a manifestation of multiples sclerosis. Mayo Clin. Proc. 40:544, 1965.
3. ARNOLD, A.C.; PEPOSE, J.S.; HEPLER, R.S. & FOOS, R.Y. - Retinal periphlebitis in multiple sclerosis: pathologic characteristics. Ophthalmology 91:255, 1984.
4. BREGER, B.B. & LEOPOLD, I.H. - The incidence of uveitis in multiple sclerosis. Amer. J. Ophthalmol. 62:540, 1966.
5. CALLEGARO, D. - Esclerose múltipla: estudo de 103 casos. Dissertação de Mestrado. FMUSP, São Paulo, 1981.
6. FRISEN, L. & HOYT, W.F. - Insidious atrophy of retinal nerve fibers in multiple sclerosis: fundoscopic identification in patients with and without visual complaints. Arch. Ophthalmol. 92:91, 1974.
7. GILES, C.L. - Peripheral uveitis in patients with multiple sclerosis. Amer. J. Ophthalmol. 70:17, 1970.
8. HAAR, M. - Retinal periphlebitis in multiple sclerosis. Acta neurol. scand. 39 (suppl. 4):270, 1963.
9. KEANE, J.R. - Ocular skew deviation: analysis of 100 cases. Arch. Neurol. 32:185, 1975.
10. PORTER, R. - Uveitis in association with multiple sclerosis. Brit. J. Ophthalmol. 56:478, 1972.
11. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis. Proc. Staff Meet. Mayo Clin. 19:176, 1944.
12. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis. J. amer. med. Assoc. 127:970, 1945.
13. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis: review of pertinent literature. Mayo Clin. Proc. 47:335, 1972.
14. TANAKA, R.; IWASAK, Y. & KOPROWSKI, H. - Ultrastructural studies of perivascular cuffing cells in multiple sclerosis brain. Amer. J. Pathol. 81:467, 1975.
15. TREUSCH, J.V. & RUCKER, C.W. - Incidence of changes in the retinal veins in multiple sclerosis. Proc. Staff Meet. Mayo Clin. 19:253, 1944.
16. WALSH, F.B. & HOYT, W.F. - Clinical Neuro-Ophthalmology. Williams & Wilkins, Baltimore, 1969, pg. 666.

Datas de Publicação

Publicação nesta coleção
09 Ago 2012
Data do Fascículo
Dez 1985

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ADAMS, C.W.M. - Pathology of multiple sclerosis: progression of the lesion. Brit. med. Bull. 33:15, 1977.

[2] 2. ARCHAMBEAU, P.L.; HOLLENHORST, R.W. & RUKER, C.W. - Posterior uveitis as a manifestation of multiples sclerosis. Mayo Clin. Proc. 40:544, 1965.

[3] 3. ARNOLD, A.C.; PEPOSE, J.S.; HEPLER, R.S. & FOOS, R.Y. - Retinal periphlebitis in multiple sclerosis: pathologic characteristics. Ophthalmology 91:255, 1984.

[4] 4. BREGER, B.B. & LEOPOLD, I.H. - The incidence of uveitis in multiple sclerosis. Amer. J. Ophthalmol. 62:540, 1966.

[5] 5. CALLEGARO, D. - Esclerose múltipla: estudo de 103 casos. Dissertação de Mestrado. FMUSP, São Paulo, 1981.

[6] 6. FRISEN, L. & HOYT, W.F. - Insidious atrophy of retinal nerve fibers in multiple sclerosis: fundoscopic identification in patients with and without visual complaints. Arch. Ophthalmol. 92:91, 1974.

[7] 7. GILES, C.L. - Peripheral uveitis in patients with multiple sclerosis. Amer. J. Ophthalmol. 70:17, 1970.

[8] 8. HAAR, M. - Retinal periphlebitis in multiple sclerosis. Acta neurol. scand. 39 (suppl. 4):270, 1963.

[9] 9. KEANE, J.R. - Ocular skew deviation: analysis of 100 cases. Arch. Neurol. 32:185, 1975.

[10] 10. PORTER, R. - Uveitis in association with multiple sclerosis. Brit. J. Ophthalmol. 56:478, 1972.

[11] 11. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis. Proc. Staff Meet. Mayo Clin. 19:176, 1944.

[12] 12. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis. J. amer. med. Assoc. 127:970, 1945.

[13] 13. RUCKER, C.W. - Sheathing of the retinal veins in multiple sclerosis: review of pertinent literature. Mayo Clin. Proc. 47:335, 1972.

[14] 14. TANAKA, R.; IWASAK, Y. & KOPROWSKI, H. - Ultrastructural studies of perivascular cuffing cells in multiple sclerosis brain. Amer. J. Pathol. 81:467, 1975.

[15] 15. TREUSCH, J.V. & RUCKER, C.W. - Incidence of changes in the retinal veins in multiple sclerosis. Proc. Staff Meet. Mayo Clin. 19:253, 1944.

[16] 16. WALSH, F.B. & HOYT, W.F. - Clinical Neuro-Ophthalmology. Williams & Wilkins, Baltimore, 1969, pg. 666.