Reddy Amit K, Lau Marisa K, Sieck Erin G, Kolfenbach Jason R, Palestine Alan G
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Am J Ophthalmol Case Rep. 2020 Apr 8;18:100683. doi: 10.1016/j.ajoc.2020.100683. eCollection 2020 Jun.
To describe two cases of retinal artery occlusion followed by contralateral amaurosis fugax associated with eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome).
Case 1 is a 57 year-old male who presented with transient vision loss in the right eye two weeks after a cilioretinal artery occlusion in the left eye. Evaluation eventually led to a diagnosis of EGPA. The patient was treated with high-dose steroids followed by systemic immunomodulatory therapy. Vision in the right eye recovered to 20/20 with no further episodes of vision loss. Case 2 is a 55 year-old male with a known diagnosis of EGPA who presented with transient vision loss in the right eye four weeks after a central retinal artery occlusion of the left eye. This patient also successfully recovered vision in the right eye after treatment with high-dose steroids following a change in his systemic immunomodulatory therapy.
While ANCA-vasculitides are an uncommon cause of retinal artery occlusion and amaurosis fugax, it is important that they remain in the differential diagnosis, as good visual outcomes can be achieved with prompt initiation of appropriate therapies.
描述两例视网膜动脉阻塞后出现对侧一过性黑矇，并与嗜酸性肉芽肿性多血管炎（EGPA，既往称为变应性肉芽肿性血管炎）相关的病例。
病例1为一名57岁男性，在左眼睫状视网膜动脉阻塞两周后出现右眼一过性视力丧失。最终评估诊断为EGPA。患者接受了大剂量类固醇治疗，随后进行全身免疫调节治疗。右眼视力恢复到20/20，未再出现视力丧失发作。病例2为一名55岁男性，已知诊断为EGPA，在左眼视网膜中央动脉阻塞四周后出现右眼一过性视力丧失。该患者在全身免疫调节治疗改变后，接受大剂量类固醇治疗，右眼视力也成功恢复。
虽然抗中性粒细胞胞浆抗体血管炎是视网膜动脉阻塞和一过性黑矇的罕见病因，但重要的是要将其保留在鉴别诊断中，因为及时启动适当治疗可取得良好的视觉效果。
