[Early ocular symptoms in Wegener's granulomatosis]

Wegener's granulomatosis is characterized by necrotizing granulomatous vasculitis that initially occurs in a localized form, disseminates in various degrees and particularly involves the respiratory tract and kidneys. Eye manifestations are common (40 to 60%). Both clinical and histopathological findings are described in eight patients with Wegener's granulomatosis. The initial ocular symptoms included conjunctivitis, episcleritis, scleritis, corneoscleral ulceration, uveitis and ocular proptosis. In one patient histological examination of the orbital tissue was consistent with limited Wegener's granulomatosis 6 years before generalized granulomatous vasculitis confirmed the underlying disease. As new diagnostic and therapeutic modalities (detection of antineutrophil cytoplasmatic autoantibodies and therapy with trimethoprim-sulfamethoxazole) exist, a knowledge of the ocular initial symptoms of Wegener's granulomatosis can have considerable significance.