Late-onset cystoid macular edema as a presenting symptom of anca-negative pauciimmune crescentic glomerulonephritis.
OBJECTIVE
The purpose of this study was to report the appearance of late-onset cystoid macular edema (CME) as an initial manifestation of antineutrophil cytoplasmic antibody-negative pauciimmune glomerulonephritis.


METHODS
Optical coherence tomography was obtained on a female patient after presentation of CME after cataract surgery in the right eye. Follow-up optical coherence tomographies were obtained after resolution of symptoms and on development and resolution of CME in the fellow eye.


RESULTS
The patient developed unilateral CME 6 months after uncomplicated cataract surgery and after a seizure was diagnosed with antineutrophil cytoplasmic antibody-negative pauciimmune glomerulonephritis. The CME resolved within 2 months of initiating topical nonsteroidal antiinflammatory drug and steroid treatment. Several months later, after undergoing uncomplicated cataract surgery in the fellow eye, the patient developed CME 4 weeks after surgery despite topical nonsteroidal antiinflammatory drug and steroid prophylaxis. The CME quickly resolved with topical treatment, and there has been no recurrent CME in either eye. Review of the literature shows a potential shared mechanism of CME and antineutrophil cytoplasmic antibody-negative pauciimmune glomerulonephritis.


CONCLUSIONS
These findings demonstrate a potential association between CME and antineutrophil cytoplasmic antibody-negative pauciimmune glomerulonephritis. Patients with this form of glomerulonephritis may benefit from pre- and postoperative topical antiinflammatory prophylaxis.
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Michelle M
MM
Kron
David N
DN
Zacks
Joshua P
JP
Vrabec