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Letters |

Transient Monocular Vision Loss Due to Churg-Strauss Syndrome Vasculitis

Kristen M. Harris Nwanyanwu, MD, MBA; Lindsey B. De Lott, MD; Wayne T. Cornblath, MD; Victor M. Elner, MD, PhD
JAMA Ophthalmol. 2013;131(1):117-119. doi:10.1001/jamaophthalmol.2013.576.
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Churg-Strauss syndrome (CSS) is a rare, systemic, antineutrophil cytoplasmic antibody–associated vasculitis involving small and medium-sized vessels that affects multiple tissues, particularly the lungs. Ophthalmologic involvement includes keratitis, conjunctival nodules, dacryoadenitis, myositis, uveitis, retinal vascular occlusion, and cranial neuropathies such as optic neuropathy.1 Transient monocular vision loss (TMVL) in CSS and the diagnosis of CSS by temporal artery biopsy (TAB) are both rare. We report a case of TMVL due to CSS vasculitis diagnosed by TAB.

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Figure 1. Radiographic findings of a 56-year-old man with Churg-Strauss syndrome diagnosed by temporal artery biopsy. A, Radiograph showing left lower-lobe atelectasis. B, Noncontrast computed tomography showing respiratory sinus opacification.

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Figure 2. Churg-Strauss syndrome histopathologic findings (original magnification ×200). A, Temporal arterial transmural leukocytic infiltrate with chiefly intimal damage (hematoxylin-eosin). B, Elastica damage beneath eosinophilic mural thrombosis (Verhoeff–Van Gieson stain). C, Fibrinoid necrosis of the temporal arterial branch (hematoxylin-eosin). D, Perivascular dermal leukocytic infiltrate containing eosinophils near a sweat gland (hematoxylin-eosin).




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