Ocular manifestations of classical and limited Wegener's granulomatosis

Wegener's granulomatosis (WG) may be subdivided into two forms, classical and limited. The latter specifically excludes renal disease and carries a better prognosis. Both forms have sight-threatening complications, but the relative incidence of ocular manifestations in each is not well documented. Patients with limited (n = 15) and classical (n = 16) WG were ophthalmologically examined. Ocular abnormalities found included orbital and nasolacrimal disease, corneo-scleral inflammation, dry eyes and retinal vein occlusion. In four patients (two from each group), no ocular disease was detected. The limited group included four potentially sight-threatening complications, compared to eight in the classical group. Overall, there was no statistically significant difference in any of the ocular manifestations between the two groups. Although treatment with corticosteroid and immunosuppressive agents has dramatically improved the prognosis of the disease, ocular morbidity is still well recognized. A combined medical and ophthalmological approach with prompt therapeutic intervention is recommended in these patients.