title: Bilateral acute angle-closure glaucoma as a first presentation of granulomatosis with polyangiitis (Wegener's).
abstract: We report a case of bilateral acute angle-closure glaucoma in a patient with undiagnosed granulomatosis with polyangiitis (Wegener's). A 59-year-old man presented with a severe headache, ocular pain, blurred vision, shortness of breath, and mild fever. Clinical examination revealed conjunctival chemosis, corneal edema, and shallow anterior chambers. Closed angles were observed bilaterally on gonioscopy. The patient was treated with intravenous mannitol, oral acetazolamide, and anti-glaucomatous eye drops. Over the following two days, his vision improved and intraocular pressures decreased. Subsequently, laser iridotomies were performed bilaterally and the patient attended consultations with our departments of respiratory medicine, nephrology, and rheumatology and was subsequently diagnosed with granulomatosis with polyangiitis. Bilateral acute angle-closure glaucoma is a very rare ocular manifestation of granulomatosis with polyangiitis. The association of this clinical entity with Wegener's granulomatosis remains unknown.
authors.affiliation: Department of Ophthalmology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Mete
authors.affiliation: Department of Ophthalmology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Sabit
authors.initials: S
authors.lastname: Kimyon
authors.affiliation: Department of Ophthalmology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Saygili
authors.affiliation: Department of Ophthalmology, Hatem Private Hospital, Gaziantep, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Pamukcu
authors.affiliation: Department of Ophthalmology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Kıvanç
authors.initials: K
authors.lastname: Güngör
mesh_terms: D000208:Acute Disease; D015812:Glaucoma, Angle-Closure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D013997:Time Factors; D015898:Tomography Scanners, X-Ray Computed; D014463:Ultrasonography