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Ocular involvement as the initial manifestation of Wegeners granulomatosis
作者:周希彬  文章来源:解放军总医院  点击数196  更新时间:2012/9/13  文章录入:毛进  责任编辑:毛进

Objectives: To evaluate the ophthalmic manifestation as the initial signs of Wegener’s Granulomatosis (WG) in China.
Patients and Methods: Retrospective chart review of WG patients in the Chinese PLA General Hospital between 1993 and 2011 was done. Initial ophthalmic manifestation, comorbidity, biopsy results, laboratory testing results, treatment and the final outcome were described.
Results: 101 patients diagnosed with WG were identified. 26 patients (25.7 %) had ocular symptoms as the first signs of WG, 15 males and 11 females, aged between 8 and 7242.19±16.04years. The most common ophthalmic manifestation was conjunctivitis (17/26, 65.4%) followed by corneal and Eyelid edema/erythema (both 10/26, 38.5%), orbital disease (6/26, 23.1%), scleral /episcleral (5/26, 19.23%), and nasolacrimal abnormalities (2/26, 7.69%). Antineutrophil cytoplasmic antibodies (ANCA) were positive in 21(21/26, 80.77%) patients. 20 patients had histological proof of WG, the six others had enough evidence to support this diagnosis. All patients received therapy with cyclophosphamide and glucocorticoids. 6 eyes of 5 patients suffered visual loss. The others achieved complete remission.
Conclusion: WG may affect any part of the eye and may present initially with ocular manifestations. Ophthalmologists play an important role in the early diagnosis and treatment of WG.

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