Plasmapheresis in the management of choroidal vasculitis associated with C-anca positive renal vasculitis.

Abstract

PURPOSE:

The purpose of this study was to report the use of plasmapheresis in the management of choroidal vasculitis associated with Wegener granulomatosis.

METHOD:

Case report.

PATIENT:

A 50-year-old woman with acute renal failure as a result of glomerulonephritis of the Wegener granulomatosis type presented with sudden visual loss. Visual acuities at presentation were counting fingers in the left eye and 6/24 in the right eye. Clinical examination showed significant choroidal ischemia with no evidence of vitritis or anterior segment inflammation. Fluorescein and indocyanine green angiography confirmed choroidal vasculitis.

RESULTS:

The patient was treated with a course of seven plasmapheresis sessions, after which she was maintained on prednisolone and mycophenolate. One week after her presentation, vision improved to 6/6 bilaterally. The angiographic appearances resolved, and the patient was maintained on immunosuppression.

CONCLUSION:

We believe that the prompt use of plasmapheresis prevented irreversible visual loss in this patient. This case illustrates the dramatic improvement in choroidal perfusion presumably resulting from the removal of a circulating immune factor.

• Authors: Erika M Damato, James T Moriarty, Steve J Harper, Andrew D Dick, Clare C Bailey
• Journal: Retinal cases & brief reports (Retin Cases Brief Rep) Vol. 4 Issue 4 Pg. 356-60 ( 2010) ISSN: 1935-1089 [Print] United States
• PMID: 25390916 (Publication Type: Journal Article)