Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Ocular manifestations in Wegener granulomatosis - a prospective study
1Nölle B., 1Schwarzer A. L., 2Reinhold-Keller E., 2Gross W. L.
1Klinik für Ophthalmologie, Hegewischstr. 2, 24105 Kiel; 2Rheumaklinik Bad Bramstedt und Poliklinik für klinische Rheumatologie der MUL Lübeck, Oskar-Alexander-Str. 26, 24576 Bad Bramstedt
Objective: Wegener granulomatosis (WG) is a frequent primary systemic
vasculitis. WG is highly associated with anti-neutrophil cytoplasmatic
autoantibodies (ANCA) with specificity for PR-3. Eye manifestations in
WG may appear up to 50% in retrospective studies, however, a prospective
controlled study is not yet available.
Methods: Between 1.1.1996 and 31.12.1998 124 WG-patients (101 histologically
proven) were investigated by ophthalmologists with slit lamp biomicroscopy
of anterior and posterior eye segments, analysis of visual acuity, sicca-symptoms,
and visual fields using a standardized protocol (mean 9x, min. 1x, max.
30x). ANCA was tested in serum, an interdisciplinary clinical approach
was performed including MRI of the orbit.
Results: Some ocular inflammatory manifestions of WG were seen
(ocular involvement one side/bilateral): sicca-syndrome (2/79), episcleritis
(25/24), scleritis (11/5), keratitis (11/3), cataracta complicata (10/30),
orbital granuloma (3/5), visual fields were normal in only 20%, defects
were graded into low, medium, and heavy, each caused one third. The various
ocular manifestations of WG were not correlated with the presence of ANCA
(105 WG ANCA+, 19 WG ANCA-), however, episcleritis was associated with
active disease (p<0.05). Initial eye symptoms due to WG were seen in
6.4% of the patients.
Conclusion: In WG vasculitic eye manifestations are more frequent
than granuloma formation. In addition, side effects of drug therapy have
to be recognized. No ocular subtype with ANCA association was found. Although
diagnosis of WG is improved by ANCA testing, and optimization of treatment
is available, WG can even today lead to blindness or loss of one eye.