Ophthalmological affections in wegener's granulomatosis
Abstract
Wegener's granulomatosis (WG) is a collagen disease, potentially lethal, it is a systemic necrotizing granulomatous vasculitis that primarily affects the respiratory tract and kidneys , it is uncommon or rare, idiopathic with a short life expectancy, without specific treatments, with Multisystemic affectations, generally a consequence of ischemia due to vascular occlusion, including ophthalmological ones, can affect almost all ocular structures..The clinical picture of a 66-year-old female patient with a history of Wegener's granulomatosis diagnosed in the CIMEQ 28 years ago with multiple manifestations was described, previous surgeries of the perinasal sinuses, breast, lung and orbit, habitual treatment Prednisone, Cyclophosphamide and Azulfidine, reaches consultation of the CIMEQ Ophthalmology Guard Corps in March 2011, reporting intense pain in the left eye. The ophthalmological examination revealed a conjunctival scleral necrosis of the entire inferior nasal bulbar area with exposure of the uveal tissue, which progressed rapidly with extensive peripheral corneal thinning. Initially, complementary tests were indicated, 3 coatings with amniotic membrane and tarsorrhaphy were performed without achieving satisfactory results, vision and eye perforation becomes imminent, loss was evaluated with various specialists, then a fistula appears that exposes material from implants from orbital surgery, He performed the explant, subsequently enucleation with a rotated temporal graft with rehabilitation (ocular prosthesis), the medical treatment and the evaluation by internal medicine has been stable Prednisone, Cyclophosphamide and Azulfidine, good vision in his only eye, although dacryocystitis has appeared for 3 years Right chronic mild, opting for conservative treatments, currently maintains complementary in normal ranges, well-tolerated outpatient medical treatment with oral Prednisone and Azulfidine, topical with artificial tears and timolol 0.5% and good quality of life.
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