Japanese

Bilateral corneal apex syndrome in a case of ANCA-associated vasculitis Junichiro Akimitsu 1,2 , Yuta Koyama 1 , Yuka Sogabe 3 , Takashi Fujimura 2 , Kiyoshi Suzuma 1 1Department of Ophthalmology, Kagawa University Faculty of Medicine 2Department of Ophthalmology, Japan Community Health Care Organization Ritsurin Hospital 3Department of Ophthalmology, Mitoyo General Hospital pp.899-905
Published Date 2020/7/15
DOI https://doi.org/10.11477/mf.1410213623
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Abstract Purpose:To report a case of ANCA-associated vasculitis who manifested bilateral for orbital apex syndrome.

Case:A 78-year-old female was referred to us for visual failure and impaired ocular motility. She had been diagnosed with ANCA-associated vasculitis six months before.

Findings and Clinical Course:Corrected visual acuity was no light percepotion right and 0.6 left. The right eye showed blepharoptosis and impaired motility in all directions. Perimetry showed concentric narrowing in the left eye. Magnetic resonance imaging(MRI)showed findings compatible with the diagnosis of bilateral orbital apex syndrome. Renal biopsy before visiting us had shown findings of ANCA-associated vasculitis. She was diagnosed with orbital apex syndrome secondary to hypertrophic pachymeningitis and ANCA-associated vasculitis. Systemic methylprednisolone was followed by improved visual acuity in both eyes. Further treatment with cyclophosphamide led to full ocular motility. Visual acuity improved to 0.9 right and 1.0 left after 23 weeks of treatment.

Conclusion:The present case illustrates that visual recovery is possible in bilateral orbital apex syndrome secondary to hypertrophic pachymeningitis and ANCA-associated vasculitis.


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