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ANA KAREN ESCALONA BRITO, Miguel Pedroza-Seres, Rosalva Bobadilla; Ocular manifestations in patients diagnosed with granulomatosis with polyangiitis.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4140.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the ocular findings and its characteristics in patients diagnosed with granulomatosis with polyangiitis during a 10 year period.
Electronic medical records of patients with granulomatosis with polyangiitis were reviewed at the Department of Uveitis, Institute of Ophthalmology “Conde de Valenciana” from January 2005 through January 2015. Demographic data, clinical findings, therapeutic approach and complications are reported.
Fifty two patients were included, with an equal distribution for both gender. Mean age for men was 50 years old and 55.5 years for women (Range 17-85 years). Average follow-up time was 3.15 years. The most common initial manifestation was scleritis (69.23%). Diffuse scleritis was present in 38.46%, necrotizing scleritis in 21.15% and nodular scleritis in 13.46%. Peripheral ulcerative keratitis with scleritis was observed in 19.23% and uveitis in 13.46% of patients. Twenty three percent of the patients were previously diagnosed and 17.3% have had systemic medical treatment. Seventy six percent of the patients were diagnosed in our Department because the ocular involvement was the first symptom of the disease. Twenty seven (51.92%) of the patients did not have systemic involvement of the disease. Upper respiratory tract involvement was the most common systemic association in 21.15% followed by renal disease in 17.30%. All the patients were treated with oral steroids and immunosuppressive drugs such as cyclophosphamide, methotrexate and azathioprine. Cataract was the most common ocular complication (13.46%) followed by glaucoma (9.61%), and perforation and corneal thinning (5.76%).Of the 104 eyes included in this analysis, during their follow up time 35.57% improved their vision at least one Snellen line of visual acuity, 29.80% lost one or more Snellen lines of visual acuity and 34.61% had no visual changes.
Scleritis was the most common ocular manifestation as reported in other series. More than 70% of our patients with granulomatosis with polyangiitis did not show systemic manifestation of their disease. Therefore our findings suggest that the ocular symptoms can orient the diagnosis even in the absence of systemic involvement. High clinical suspicion determines a rapid onset of medical treatment for this potentially lethal disease and a better prognosis with lower risk of vision loss.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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