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Abstract
Case summary
A-48-year-old man visited our clinic complaining of suddenly decreased visual acuity in the left eye. Two months previously he had an operation for sinusitis, and he had been taking medications for asthma. In the initial examination, his best corrected visual acuity was 0.02 in the left eye. Fundus examination showed whitish, multiple, diffuse ischemic lesions around the posterior pole and slightly engorged retinal veins in the left eye. Fluorescein angiography showed delayed choroidal filling and delayed arteriovenous transit time in the left eye, but no apparently visible obstruction site. The eosinophil count was elevated to 65% in the white blood cell differentiated count, and perinuclear antineutrophil cytoplasmic antibodies (ANCA) with antimyeloperoxidase specificity (MPO-ANCA) was increased, but a chest X-ray was normal. Eosinophil infiltrations in the mucosa of the paranasal sinus were found, and peripheral neuropathy was found in a nerve conduction study. Hence, we diagnosed the patient with Churg-Strauss syndrome accompanied by occlusive retinal vasculitis, and started steroid therapy. Thirty days later after steroid therapy, the best corrected visual acuity of the left eye was 0.4.
References
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Figure 1.
(A) Fundus photograph shows whitish, multiple, diffuse ischemic lesions around the posterior pole and slightly engorged retinal veins in the left eye. (B) Fluorescein angiograph shows delayed choroidal filling and delayed arteriovenous transit time (more than 1 minute) in the left eye, but no apparently visible obstruction site.
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