A case of orbital Polyarteritis Nodosa Complicated with Retinal Vasculitis and Exophthalmos.

Kim, Hyun Gue; Lee, Su Hyung; Kim, In Taek

Original Article

Journal of the Korean Ophthalmological Society 2003;44(1):215-219.
Published online January 1, 2003.

A case of orbital Polyarteritis Nodosa Complicated with Retinal Vasculitis and Exophthalmos.

¹Department of Ophthalmology, Ulsan Dong-Kang Hospital, Korea.
²Department of Ophthalmology, School of Medicine, Kyungpook National University, Korea. itkim@knu.ac.kr

망막혈관염과 안구돌출과 합병된 안와의 결절성다발동맥염

김현규 ( Hyun Gue Kim ) , 이수형 ( Su Hyung Lee ) , 김인택 ( In Taek Kim )

Abstract

PURPOSE
Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small sized arteries throughout the vascular system, including ocular tissues. We report a case of orbital polyarteritis nodosa complicated with retinal vasculitis and exophthalmos. METHODS: A 51-year-old woman complained of swelling and hard mass in periorbital region for 3 months. The left eye was anophthalmos after enucleation secondary to corneal infection. The patient has treated marginal ulcer of the cornea and keratomalacia. Posterior synechia and motility disturbance of lateral rectus muscle were also revealed. Fundus examination showed focal retinal hemorrhage, macular hard exudate, and soft exudate, which may mean retinal vasculitis. Both eyes gradually developed exophthalmos. Orbital CT scan revealed homogenous infiltration in the orbit, ethmoid bone, and nasal cavity and perforation of the nasal septum. The pathologic examination for the biopsy specimen from the orbital tissue demonstrated a nongranulomatous vasculitis, diagnosing the polyarteritis nodosa. RESULTS: The authors present ocular manifestations, including marginal corneal ulcer, keratomalacia, dysfunction of the extraocular muscles, posterior synechia, retinal hemorrhage, soft exudate, hard exdate in the macula, and exophthalmos, in this patient with the polyarteritis nodosa.

Key Words: Exophthalmos;Polyarteritis nodosa;Retinal vasculitis