Mangouritsas G, Ulbig M
Universitäts-Augenklinik, Würzburg, Germany.
Ger J Ophthalmol. 1994 Mar;3(2):68-70.
Various ocular manifestations have been described in Wegener's granulomatosis. Orbital involvement is common and manifestations in the anterior segment of the eye such as keratitis, scleritis, and conjunctivitis may occur. Involvement of the posterior segment presenting with major vascular occlusions or anterior ischemic neuropathy is rare. This case report presents a patient with bilateral cotton-wool spots at the posterior pole associated with histologically proven Wegener's granulomatosis. This finding, as an initial ocular manifestation of the disease, is very uncommon and may be interpreted as focal retinal inflammatory vasculitis. This was supported by the rapid positive response to systemic combined immunosuppressive and steroidal treatment during a 30-month period of review. The presence of cotton-wool spots in association with systemic signs of the disease should be considered in establishing the diagnosis of Wegener's granulomatosis.
韦格纳肉芽肿病有多种眼部表现。眼眶受累很常见，眼部前段如角膜炎、巩膜炎和结膜炎等表现也可能出现。后段受累表现为主要血管阻塞或前部缺血性神经病变则较为罕见。本病例报告介绍了一名患者，其双眼后极部出现棉絮斑，组织学检查证实为韦格纳肉芽肿病。这一发现作为该疾病的初始眼部表现非常罕见，可能被解释为局灶性视网膜炎性血管炎。在30个月的观察期内，对全身联合免疫抑制和类固醇治疗的快速阳性反应支持了这一点。在诊断韦格纳肉芽肿病时，应考虑棉絮斑与该疾病全身症状同时出现的情况。
