Simultaneous bilateral central retinal artery occlusion in churg-strauss syndrome

Retinal vascular abnormalities are rare in patients with Churg-Strauss syndrome. We present the findings in a patient with Churg-Strauss syndrome who developed bilateral central retinal artery occlusion simultaneously.

Case report.

A 68-year-old Japanese man developed acute bilateral vision decrease to counting finger in the right eye and hand movements in the left eye. Ophthalmoscopic and angiographic examinations revealed a central retinal artery occlusion with choroidal circulatory disturbances in both the eyes. The patient had bronchial asthma, hypereosinophilia, radiographically determined migratory pulmonary opacities, and paranasal sinus abnormalities, thus fulfilling the American College of Rheumatology criteria for Churg-Strauss syndrome. Antineutrophil cytoplasmic antibody was absent. High-dose steroid therapy was used, but after 6 weeks, his visual acuity in the right eye did not improve, and the vision in the left eye was no light perception. Later, vitreous hemorrhage was developed in the left eye followed by retinal detachment associated with proliferative retinopathy.

Bilateral central retinal artery occlusion can occur in patients with antineutrophil cytoplasmic antibody-negative Churg-Strauss syndrome. The cause of the central retinal artery occlusion is not known, but consideration for prophylactic steroid therapy may be recommended in antineutrophil cytoplasmic antibody-negative cases to prevent potential visual loss.