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Exudative retinal detachment and scleritis in polyarteritis.

R A Kielar

    American Journal of Ophthalmology
    |November 1, 1976
    PubMed
    Summary
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    A patient on long-term corticosteroids developed polyarteritis and severe scleritis, leading to eye enucleation. Histopathology revealed granulomatous scleritis and retinal detachment, with minimal systemic symptoms.

    Area of Science:

    • Ophthalmology
    • Rheumatology
    • Pathology

    Background:

    • Long-term systemic corticosteroid use is a known risk factor for various complications.
    • Polyarteritis nodosa is a systemic vasculitis that can affect multiple organs.

    Observation:

    • A 64-year-old man on five years of corticosteroids developed polyarteritis and severe scleritis in his right eye.
    • The affected eye became blind, painful, and required enucleation 23 months after scleritis onset.

    Findings:

    • Histopathology of the enucleated eye showed granulomatous scleritis, chronic nongranulomatous uveitis, exudative retinal detachment, and perivasculitis.
    • Systemic findings included elevated sedimentation rate, weight loss, mild anemia, and microscopic hematuria, with absence of respiratory, severe kidney disease, hypertension, or arthritis.

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    Implications:

    • This case highlights a rare presentation of corticosteroid-induced polyarteritis with severe ocular manifestations.
    • Granulomatous scleritis and retinal detachment can occur in the context of systemic vasculitis, even with minimal systemic involvement.
    • Muscle biopsy confirmed the diagnosis, underscoring its importance in diagnosing systemic conditions with atypical presentations.