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Bilateral optic neuritis in wegener granulomatosis.
Mário Luiz Ribeiro Monteiro1, Wander Inturias Sergillo Borges, Carolina do Val Ferreira Ramos
1Department of Ophthalmology, Hospital das Clínicas of the University of São Paulo Medical School, São Paulo, Brazil. mlrmonteiro@terra.com.br
Summary
Wegener granulomatosis (WG) can cause severe vision loss due to optic nerve inflammation. Early diagnosis and aggressive treatment are crucial for preventing irreversible vision loss in patients with WG.
Area of Science:
- Ophthalmology
- Rheumatology
- Otolaryngology
Background:
- Recurrent sinusitis can present with severe complications.
- Optic neuropathy is a serious condition affecting vision.
Observation:
- A 32-year-old patient experienced severe visual loss due to optic neuropathy.
- Imaging showed extensive paranasal sinus destruction and inflammation extending to optic canals and orbital fissures.
- Endoscopic biopsy revealed granulomatous vasculitis consistent with Wegener granulomatosis (WG).
Findings:
- Granulomatous vasculitis, indicative of WG, was diagnosed via sinusectomy and biopsy.
- Aggressive treatment with corticosteroids and cyclophosphamide resulted in rapid visual recovery.
Implications:
- Optic neuritis can be an early sign of WG.
- Prompt diagnosis and treatment are vital to prevent irreversible vision loss from arterial inflammation and infarction.