A Suspected Case of Wegener’s Granulomatosis with Ocular Symptom

Abstract

Wegener’s granulomatosis is characterized by necrotising granulomas of the respiratory tract, renal failure and necrotising angitis. We report herein on a case of a 53-year-old man who presented with visual disturbance of the right eye. He had also presented with visual disturbance one year previously, and underwent endoscopic sinus surgery at another hospital. We considered that the visual disturbance was caused by a sinus cyst. Although we performed endoscopic sinus surgery, the patient’s visual loss did not improve. About one month after the surgery, bilateral visual disturbance and nasal septum perforation appeared, the p-ANCA titer was elevated, and pachymeningitis became apparent, but the left paranasal sinus was intact. Finally we diagnosed that the visual loss was due to pachymeningitis based on Wegener’s granulomatosis, and we therefore administered prednisolone and cyclosporin. The eyesight in the patient’s right eye was still poor but his left eyesight recovered.