Aim Polymyalgia rheumatica is an increasingly common disease in older people, which gives rise to arthralgia and is mainly treated with corticosteroids. Central retinal artery occlusion is one of the common causes of visual loss in polymyalgia rheumatica. On the contrary, central retinal vein occlusion is rarely associated with polymyalgia rheumatica.
Methods case reports .
Results An 63-year-old man presented with painless loss of vision in the oculus uterque over a 6-month period. Further history revealed a 24-month history of aching of the shoulder and hip girdle, with morning stiffness.He has also present with manifest joint synovitis. an acute rise in inflammatory markers including an elevated erythrocyte sedimentation rate of 75 mm/hr. Thrombophilia markers were negative. An abnormal temporal artery biopsy confirme Giant cell arteritis(GCA). Polymyalgia rheumatica was diagnosed byPekingUnionMedicalCollegeHospital. Start treatment with glucocorticosteroids in the form of prednisone. That has greatly improve symptoms. His pertinent past medical history included controlled hypertension since 2007 with mean arterial pressure of 120 mmHg. On examination, his best-corrected visual acuity was 20/40 OD and 10/40 OS. IOP was normal .Anterior segments revealed bilateral cortical cataract. Neuro-ophthalmic examination showed normal extraocular motility.Fundoscopy of the eye revealed the retinal vascular tortuosity , retinal capillary nonperfusion ,enlarged retinal vein and macular edema suggestive of CRVO.This was confirmed with fundus fluorescein angiography.
Conclusions To our knowledge, this is the first reported case of CRVO in an elderly man with polymyalgia rheumatica. Among a wide variety of ophthalmic manifestations of polymyalgia rheumatica, CRAO is the second most common cause of polymyalgia rheumatica-related visual loss after anterior ischemic optic neuropathy. However, a relationship between retinal vein occlusion and polymyalgia rheumatica is rare.In conclusion ,patients with polymyalgia rheumatica can present with retinal vein occlusion. |
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