Acute painless monocular visual loss due to central retinal artery occlusion in a patient with Churg-Strauss vasculitis.
Ocular involvement in Churg-Strauss syndrome (CSS) is infrequent. We describe a case of a 50-year-old woman, with blood eosinophilia, involvement of the respiratory tract, skin, and peripheral nervous system, fulfilling the American College of Rheumatology criteria for CSS, who presented with left foot drop followed by left acute painless visual loss. Central retinal artery occlusion was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). CSS was confirmed by sural nerve biopsy. Despite treatment with high-dose corticosteroids, cyclophosphamide, and anticoagulant therapy, visual acuity was not substantially improved. Acute blindness in CSS has been rarely described. Even more rarely, central retinal artery occlusion has been found to be the underlying cause of this infrequent clinical manifestation in CSS.
1st Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece. iskrapari@yahoo.gr
Ioanna
I
Skrapari
Eleftheria
E
Kagkelari
Evangelos
E
Charitatos
Catherine
C
Pantelidaki
Theodoros
T
Gounaris
Evagelia
E
Sioula
D000925:Anticoagulants / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009887:Ophthalmoscopy; D012161:Retinal Artery / Q000473:pathology*; D015356:Retinal Artery Occlusion / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome; D015354:Vision, Low / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D000925:Anticoagulants; D005938:Glucocorticoids; D003520:Cyclophosphamide