Survey of Ophthalmology
Volume 49, Issue 4 , Pages 399-418, July 2004

Ocular manifestations and concepts of systemic vasculitides

1Massachusetts Eye and Ear Infirmary, Immunology and Uveitis Service, Harvard Medical School, Boston, Massachussetts; 2Cleveland Clinic Foundation, Cole Eye Institute, Cornea and Uveitis Service, Cleveland, Ohio; and 3University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA

Abstract 

Vasculitic disorders are relatively rare. Their etiology and pathophysiology remain enigmatic, leading to confusing nomenclature and multiple classification schemes. Untreated vasculitis can be fatal. Early diagnosis is the key to successful treatment and better prognosis. However, early diagnosis can be difficult; vasculitic conditions usually present with non-specific symptoms for a long period before clinically overt manifestations occur. Ophthalmologists should be familiar with the ocular manifestations of the vasculitic disorders because they may not only be sight-threatening, but more importantly could be the presenting manifestations of active, potentially lethal systemic disease. This review summarizes clinical and ocular manifestations of systemic vasculitic disorders. Furthermore, it discusses general concepts in diagnosis and treatment of these diseases in an effort to provide a practical framework for the ophthalmologist evaluating patients with vasculitis.

Keywords:  Churg-Strauss syndrome, cutaneous leukocytoclastic angiitis, giant cell arteritis, Henoch-Schönlein purpura, Kawasaki disease, microscopic polyangiitis, ocular manifestations, polyarteritis nodosa, primary vasculitis, Takayasu's arteritis, Wegener's granulomatosis

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 The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(04)00088-8

doi:10.1016/j.survophthal.2004.04.008

Survey of Ophthalmology
Volume 49, Issue 4 , Pages 399-418, July 2004