Ischemic optic neuritis in Churg-Strauss syndrome

Area of Science:

• Ophthalmology
• Neurology
• Rheumatology

Background:

• Churg-Strauss syndrome (CSs) is a rare condition characterized by asthma, eosinophilia, and vasculitis.
• Neuro-ophthalmologic manifestations in CSs are infrequently reported.
• This study focuses on a specific case of visual impairment in a CSs patient.

Observation:

• A 46-year-old male with known CSs presented with severe asthma, allergic rhinitis, hypereosinophilia, and peripheral neuropathy.
• The patient experienced significant vision loss in his right eye, with visual acuity reduced to light perception.
• Ophthalmoscopic examination revealed a pale optic disc, and fluorescein angiography showed hypofluorescence.

Findings:

• The case presents unilateral optic atrophy in a patient diagnosed with Churg-Strauss syndrome.
• Diagnostic findings included severe bronchial asthma, allergic rhinitis, hypereosinophilia (8%), and peripheral neuropathy.
• Ophthalmoscopy and fluorescein angiography indicated optic disc abnormalities consistent with reduced blood flow.

Implications:

• This case suggests that vasculitis affecting the ciliary arteries may be the underlying cause of optic atrophy in CSs.
• It underscores the importance of considering neuro-ophthalmologic evaluations in patients with Churg-Strauss syndrome.
• Early recognition and management of ocular complications may be crucial for preserving vision in affected individuals.