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Simultaneous central retinal artery occlusion and optic nerve vasculitis in Crohn disease

By Razek Georges Coussa, Andre Ali-Ridha, Natalia Vila, Rayan Alshareef and John Chen

Abstract

AbstractPurposeTo describe a case of Crohn disease presenting as occlusive vasculitis resulting in a central retinal artery occlusion (CRAO) in one eye and transient ischemic optic neuropathy in the fellow eye.ObservationsAn 18-year-old patient recently diagnosed with biopsy-proven Crohn disease presented with CRAO OD after a previous episode of transient visual loss OS. Extensive workup was negative for other autoimmune or infectious etiologies. The patient was started on intravenous methylprednisolone for 72 h followed by maintenance dose of azathioprine and oral prednisone. Signs of inflammation resolved gradually with some improvement of visual acuity despite developing optic atrophy.Conclusionand importance: To our knowledge, this is the first case of unilateral CRAO and bilateral optic nerve occlusive vasculitis in Crohn disease, which should be considered as an etiology of retinal vascular occlusive disorders especially in young patients. It is important for ophthalmologists to be aware of the ophthalmic risks associated with Crohn disease as aggressive treatment with systemic steroids and immunosuppressive agents is often needed

Publisher: The Authors. Published by Elsevier Inc.
Year: 2017
DOI identifier: 10.1016/j.ajoc.2016.10.004
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