Diagnosis and management of systemic Wegener's granulomatosis presenting with anterior ocular inflammatory disease. Issue 4 (April 1991)

• Record Type: Journal Article
• Authors: Charles, S J; Meyer, P A; Watson, P G
• Is Part Of: British journal of ophthalmology. Volume 75:Issue 4(1991)
• Page Start: 201
• Page End: 207
• Publication Date: 1991-04
• Subjects: Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.75.4.201
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : The ocular and systemic features of 10 patients whose Wegener's granulomatosis presented with corneoscleral inflammatory disease are described. Marginal corneal infiltrates were seen in all patients with anterior scleritis and were a valuable sign of disease activity. Nine out of 10 patients had symptoms of systemic vasculitis on presentation; seven had renal impairment; three had chest x-ray abnormalities. Autoantibodies against neutrophil cytoplasmic determinants (ANCA) were present in all cases. In seven patients the scleritis responded well to pulsed immunosuppressive therapy followed by long term oral steroids and cyclophosphamide. Oral steroid therapy alone failed to control severe disease. Corneoscleral disease was not a cause of visual loss. It is important to realise that inflammatory corneoscleral disease may be the presenting feature of a severe systemic vasculitis.