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Exsudative Retinal Detachment in a Patient with Wegener´s Granulomatosis

Sherif Z., Tetz M.,
Humboldt-Universität zu Berlin, Charité Campus Virchow-Klinikum, Augenklinik (Berlin)

Background: Exsudative retinal detachment is a rare complication in inflammatory or degenerative diseases of the sclera and uvea. Wegener´s granulomatosis is characterised by granulomatous inflammation within the respiratory tract, glomerulonephritis and systemic vasculitis. Ocular involvement includes scleritis, anterior and posterior uveitis and retinal vasculitis.
Patient: We report of a patient who developed multiple ocular complications in association to Wegener´s granulomatosis. He presented with superior limbitis, acute temporal scleritis and subtotal retinal detachment with high folds in the temporal quadrant but without any retinal hole. The patient´s history included terminal renal insufficiency, c-ANCA-pos. vasculitis and arterial hypertension.
Results: Because of the acute inflammatory process we initiated a corticosteroid-therapy with prednisolone 750mg i.v. which was followed by an immunosuppressive therapy with cyclophosphamide 50mg p.m.. The follow up revealed a reduction of inflammatory activity within the scleritic area as well a re-attachment of the retina.
Conclusions: Initial high-dose corticosteroid therapy in patients with exsudative retinal detachment associated with Wegener´s granulomatosis may support resorption of subretinal fluid and lead to re-attachment of the retina.

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