A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery

Kamata, Yuki; Hashizume, Kouhei; Kaneko, Masaru; Kurosaka, Daijiro

doi:10.4103/0301-4738.112164

Cited by 8 publications

(3 citation statements)

References 5 publications

(12 reference statements)

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“…When ANCA-associated vasculitis is complicated by eye symptoms, therapeutic intervention with steroids is generally considered necessary. [ 30 ] Although the prognosis of CRAO due to ANCA-associated vasculitis is generally considered to be poor, early therapeutic intervention may result in the recovery of a relatively favorable VA. [ 18 ] In our patient, the improvement of VA might have been due to the fact that steroid semi-pulse therapy was also initiated soon after she became aware of the sudden decreased of VA. Hence, and as our findings indicate, in patients with CRAO associated with general symptoms, it is important to perform detailed physical examinations, including a blood test, as needed, in order to identify the cause, and to start treatment early, while keeping the possibility of conditions secondary to ANCA-associated vasculitis in mind.…”

Section: Discussionmentioning

confidence: 89%

Development of central retinal artery occlusion accompanied by choroidal folds in a patient with antineutrophil cytoplasmic antibody-associated vasculitis

et al. 2020

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Rationale: We report a case of central retinal artery occlusion (CRAO) accompanied by choroidal folds in a patient positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA). Patient concerns: The study involved a 67-year-old female patient who presented at the Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan on October 24, 2016 after becoming aware of a sudden decrease of visual acuity (VA) in her right eye. Other than suffering with scleritis 6-months previous, there was no obvious past history. Diagnosis: Upon examination, the VA in her right eye was hand motion, and the anterior segment of that eye showed thinning of the superior sclera. Macular edema in the inner retina and cherry red spots were observed in the ocular fundus, and optical coherence tomography (OCT) findings showed hyperreflectivity of the inner retina and choroidal folds. Fluorescein angiography (FA) examination of the fundus showed scattered areas of no retinal perfusion, and indocyanine green angiography (IA) findings of the fundus indicated a possible choroidal circulatory disturbance in her right eye. Blood test findings revealed the patient to be positive for MPO-ANCA. Based on the above findings, the patient was diagnosed with CRAO and choroidal circulatory disturbance due to ANCA-associated vasculitis. Interventions: For treatment, steroid semi-pulse therapy was initiated. Outcomes: Post treatment initiation, the fundus features and choroidal folds gradually improved, and her VA slightly improved to 0.08. Lessons: Based on the FA, IA, and OCT findings, the present case was considered to have CRAO accompanied by choroidal circulatory disturbance due to ANCA-associated vasculitis, a rare disease that may be complicated by choroidal circulatory disturbances.

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Section: Discussionmentioning

confidence: 89%

Development of central retinal artery occlusion accompanied by choroidal folds in a patient with antineutrophil cytoplasmic antibody-associated vasculitis

et al. 2020

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“…1,4 Early initiation of pulse-dose steroids may improve visual outcomes. Kamata et al 6 reported a case of antineutrophil cytoplasmic antibody-negative CRAO in a patient with eosinophilic granulomatosis with polyangiitis who had good visual recovery to 20/30 after initiation of pulse ster oid therapy. Reddy et al 3 reported 2 cases of eosinophilic granulomatosis with polyangiitis following amaurosis fugax.…”

Section: Discussionmentioning

confidence: 99%

Central Retinal Artery Occlusion Leading to Diagnosis of Eosinophilic Granulomatous Polyangiitis After Adenovirus Vector COVID-19 Vaccination

Moses,

Fischer,

Elston

et al. 2024

Journal of VitreoRetinal Diseases

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Purpose: To present a case of central retinal artery occlusion (CRAO) leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) within 1 week of an adenovirus vector COVID-19 vaccination. Methods: A case was reviewed. Results: A 50-year-old man with atopic dermatitis and asthma presented with acute painless vision loss in 1 eye. An examination and imaging findings showed CRAO. Further evaluation found eosinophilia and elevated inflammatory markers. A workup for vasculitis showed elevated cytoplasmic-antineutrophil cytoplasmic antibody, perinuclear-antineutrophil cytoplasmic antibody, myeloperoxidase antibody, rheumatoid factor, and total immunoglobulin E. Skin biopsies were consistent with eosinophilic granulomatosis with polyangiitis. Steroids, cyclophosphamide, and mepolizumab were initiated. At 1 year, the patient’s systemic symptoms had improved but his vision had not. Conclusions: Few reports exist of CRAO associated with eosinophilic granulomatosis with polyangiitis, with no other instances related to an adenovirus vector COVID-19 vaccination. Treating a systemic vasculitis early can be vision saving in the fellow eye and prevent systemic life-threatening complications.

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“…As in the other diseases of this group, conjunctivitis, episcleritis, scleritis, and PUK are the more common manifestations of eosinophilic GPA [77]. Amaurosis fugax, retinal artery occlusions, ischemic optic neuropathy, dacryoadenitis, and orbital inflammation have been described [78][79][80][81][82][83].…”

Section: Microscopic Polyangiitis This Subtype Characteristically Pre...mentioning

confidence: 99%

Systemic Vasculitis and Its Association with the Eye

Carreño¹,

Olivas-Vergara²

2023

Ophthalmologica

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Vasculitis are a group of diseases characterize by the inflammation of the blood vessel walls. They are classified according to the size of the main vessel involved: in large vessel, medium vessel, and small vessel vasculitis. Ophthalmic manifestations are quite common in most of these diseases. Being episcleritis and scleritis the most prevalent manifestation of vasculitis. However, there are certain ocular diseases especially characteristic of specific vasculitis entities. Given the severity and potential life-threat of these diseases, knowledge of the ocular manifestations is mandatory for the ophthalmologists.

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A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery

Cited by 8 publications

References 5 publications

Development of central retinal artery occlusion accompanied by choroidal folds in a patient with antineutrophil cytoplasmic antibody-associated vasculitis

Development of central retinal artery occlusion accompanied by choroidal folds in a patient with antineutrophil cytoplasmic antibody-associated vasculitis

Central Retinal Artery Occlusion Leading to Diagnosis of Eosinophilic Granulomatous Polyangiitis After Adenovirus Vector COVID-19 Vaccination

Systemic Vasculitis and Its Association with the Eye

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