Inflammation in the tissue surrounding the optic nerve (perineuritis) can occur in Wegener's granulomatosis.


Clinical features of optic perneuritis (OPN):

(1) blurring of vision

(2) visual loss often with preservation of central vision (paracentral or arcuate field defects)

(3) ocular pain

(4) disc edema

(5) dramatic response to corticosteroids


Reasons to suspect Wegener's granulomatosis (Purvin and Kawasaki):

(1) steroid dependency (recurrence of symptoms with tapering of steroids)

(2) presence of upper respiratory tract (sinusitis, other) and/or rheumatic and/or renal disorder

(3) presence of anti-neutrophil cytoplasmic antibodies (ANCA)

(4) elevated acute phase reactants (CRP, ESR, other)


Other ophthalmologic findings that may be present in Wegener's granulomatosis:

(1) scleritis

(2) retinal vasculitis

(3) orbital inflammation

(4) keratitis


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