Korean J Ophthalmol.  2012 Dec;26(6):469-472. 10.3341/kjo.2012.26.6.469.

Anterior Ischemic Optic Neuropathy in a Patient with Churg-Strauss Syndrome

• Lee JE
• Lee SU
• Kim SY
• Jang TW
• Lee SJ

• KMID: 1499688
• DOI: http://doi.org/10.3341/kjo.2012.26.6.469

Abstract

We describe a patient with Churg-Strauss syndrome who developed unilateral anterior ischemic optic neuropathy. A 54-year-old man with a history of bronchial asthma, allergic rhinitis, and sinusitis presented with sudden decreased visual acuity in his right eye that had begun 2 weeks previously. The visual acuity of his right eye was 20 / 50. Ophthalmoscopic examination revealed a diffusely swollen right optic disc and splinter hemorrhages at its margin. Goldmann perimetry showed central scotomas in the right eye and fluorescein angiography showed remarkable hyperfluorescence of the right optic nerve head. Marked peripheral eosinphilia, extravascular eosinophils in a bronchial biopsy specimen, and an increased sedimentation rate supported the diagnosis of Churg-Strauss syndrome. Therapy with methylprednisolone corrected the laboratory abnormalities, improved clinical features, and preserved vision, except for the right central visual field defect. Early recognition of this systemic disease by ophthalmologists may help in preventing severe ocular complications.

Keyword

Churg-Strauss syndrome; Ischemic optic neuropathy; Papilledema

MeSH Terms

Biopsy
Churg-Strauss Syndrome/*complications/diagnosis
Diagnosis, Differential
Fluorescein Angiography
Fundus Oculi
Humans
Male
Middle Aged
Ophthalmoscopy
Optic Neuropathy, Ischemic/diagnosis/*etiology
Visual Acuity
Visual Field Tests

Figure

• 

  Fig. 1 (A) Fundus photograph of the right eye. Diffusely swollen optic disc and splinter hemorrhages along the superotemporal arcade. (B) Goldmann perimetry revealed central scotoma. (C) Fundus fluorescein angiograms of the right eye demonstrate localized filling delays of the optic disc. Optic disc filling delay is an important feature for the diagnosis of anterior ischemic optic neuropathy. (D) Late hyperfluorescence of the right optic nerve and splinter hemorrhages at the disc margin in the right eye are seen.

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