PMID- 32871935
OWN - NLM
STAT- MEDLINE
DCOM- 20200909
LR  - 20220416
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 35
DP  - 2020 Aug 28
TI  - Development of central retinal artery occlusion accompanied by choroidal folds in 
      a patient with antineutrophil cytoplasmic antibody-associated vasculitis: A case 
      report.
PG  - e21934
LID - 10.1097/MD.0000000000021934 [doi]
LID - e21934
AB  - RATIONALE: We report a case of central retinal artery occlusion (CRAO) 
      accompanied by choroidal folds in a patient positive for myeloperoxidase 
      (MPO)-antineutrophil cytoplasmic antibody (ANCA). PATIENT CONCERNS: The study 
      involved a 67-year-old female patient who presented at the Department of 
      Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan on October 24, 
      2016 after becoming aware of a sudden decrease of visual acuity (VA) in her right 
      eye. Other than suffering with scleritis 6-months previous, there was no obvious 
      past history. DIAGNOSIS: Upon examination, the VA in her right eye was hand 
      motion, and the anterior segment of that eye showed thinning of the superior 
      sclera. Macular edema in the inner retina and cherry red spots were observed in 
      the ocular fundus, and optical coherence tomography (OCT) findings showed 
      hyperreflectivity of the inner retina and choroidal folds. Fluorescein 
      angiography (FA) examination of the fundus showed scattered areas of no retinal 
      perfusion, and indocyanine green angiography (IA) findings of the fundus 
      indicated a possible choroidal circulatory disturbance in her right eye. Blood 
      test findings revealed the patient to be positive for MPO-ANCA. Based on the 
      above findings, the patient was diagnosed with CRAO and choroidal circulatory 
      disturbance due to ANCA-associated vasculitis. INTERVENTIONS: For treatment, 
      steroid semi-pulse therapy was initiated. OUTCOMES: Post treatment initiation, 
      the fundus features and choroidal folds gradually improved, and her VA slightly 
      improved to 0.08. LESSONS: Based on the FA, IA, and OCT findings, the present 
      case was considered to have CRAO accompanied by choroidal circulatory disturbance 
      due to ANCA-associated vasculitis, a rare disease that may be complicated by 
      choroidal circulatory disturbances.
FAU - Takagi, Mai
AU  - Takagi M
AD  - Department of Ophthalmology, Osaka Medical College.
FAU - Kobayashi, Takatoshi
AU  - Kobayashi T
AD  - Department of Ophthalmology, Osaka Medical College.
FAU - Kida, Teruyo
AU  - Kida T
AD  - Department of Ophthalmology, Osaka Medical College.
FAU - Takai, Nanae
AU  - Takai N
AD  - Department of Ophthalmology, Osaka Medical College.
FAU - Shoda, Hiromi
AU  - Shoda H
AD  - Department of Ophthalmology, Osaka Medical College.
FAU - Maruyama, Koichi
AU  - Maruyama K
AD  - Maruyama Eye Clinic, Takatsuki.
FAU - Tada, Rei
AU  - Tada R
AD  - Tada Eye Clinic, Ikeda.
FAU - Makino, Shigeki
AU  - Makino S
AD  - Department of Internal Medicine, Osaka Medical College, Takatsuki-City, Osaka, 
      Japan.
FAU - Ikeda, Tsunehiko
AU  - Ikeda T
AD  - Department of Ophthalmology, Osaka Medical College.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Glucocorticoids)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Aged
MH  - Anti-Inflammatory Agents/administration & dosage
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications
MH  - Azathioprine/administration & dosage
MH  - Choroid Diseases/diagnostic imaging/drug therapy/*etiology
MH  - Female
MH  - Fluorescein Angiography
MH  - Glucocorticoids/administration & dosage
MH  - Humans
MH  - Prednisolone/administration & dosage
MH  - Pulse Therapy, Drug
MH  - Retinal Artery Occlusion/diagnostic imaging/drug therapy/*etiology
MH  - Tomography, Optical Coherence
MH  - Vision, Low/etiology
PMC - PMC7458181
COIS- There is no funding to report and the authors have no conflicts of interest to 
      disclose.
EDAT- 2020/09/03 06:00
MHDA- 2020/09/10 06:00
PMCR- 2020/08/28
CRDT- 2020/09/03 06:00
PHST- 2020/09/03 06:00 [entrez]
PHST- 2020/09/03 06:00 [pubmed]
PHST- 2020/09/10 06:00 [medline]
PHST- 2020/08/28 00:00 [pmc-release]
AID - 00005792-202008280-00078 [pii]
AID - MD-D-19-10057 [pii]
AID - 10.1097/MD.0000000000021934 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Aug 28;99(35):e21934. doi: 
      10.1097/MD.0000000000021934.