| Presentation preference | Poster presentation |
| Title | Optic disk granuloma in eosinophilic granulomatosis with polyangiitis: a multimodal imaging case report |
| Purpose | To report a multimodal imaging case of optic disk granuloma in eosinophilic granulomatosis with polyangiitis (EGPA) |
| Methods | A 81-year-old man was referred for a juxtapapillary fundus lesion of his left eye, discovered during a routine ophthalmologic examination for EGPA follow-up.
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| Results | While right fundus examination was normal, left fundus examination showed a juxtapapillary lesion with perilesional arterial vasculitis, and surrounding exudates. In B-mode ultrasound, the lesion was hyperechogenic and associated with a retinal thickening. Optical coherence tomography showed significant intraretinal edema and the choroidal lesion presenting an heterogenous center with concentrical alternating hyper and hyporeflective rings.
Etiological assessment, including a comprehensive clinical and laboratory workup found no argument for an infectious or malignant origin. The presumed diagnosis of EGPA-related inflammatory granuloma was retained and intensification of treatment was proposed with methylprednisolone. During follow-up, arterial vasculitis cleared out and the lesion thickness decreased on OCT. |
| Conclusion | EGPA is a rare systemic antineutrophil cytoplasmic antibody-associated vasculitis characterized by eosinophilic infiltration and small-vessel vasculitis. To our knowledge, this is the first description of a choroidal granuloma associated with EGPA with an OCT scan presumably showing necrosis. This report describes the clinical and multimodal imaging characteristics of this granuloma and the similarity of OCT features with an histopathological section of a proven EGPA-associated granuloma from a skin biopsy.
OCT is a valuable tool to refine the diagnosis of retinal pseudo-tumors. |
| Conflict of interest | No |
Authors 1
| Last name | BOURDIN |
| Initials of first name(s) | A |
| Department | Ocular oncology Departement, Institut Curie |
| City | Paris |
| Country | France |
Authors 2
| Last name | MATET |
| Initials of first name(s) | A |
| Department | Ocular oncology Departement, Institut Curie, and UFR of Medicine University of Paris City |
| City | Paris |
| Country | France |
Authors 3
| Last name | BLIN |
| Initials of first name(s) | H |
| Department | Ophthalmology Department, Amiens University Hospital |
| City | Amiens |
| Country | France |
Authors 4
| Last name | BARNHILL |
| Initials of first name(s) | R |
| Department | Department of Translational Research, Institut Curie, and UFR of Medicine University of Paris City |
| City | Paris |
| Country | France |
Authors 5
| Last name | CASSOUX |
| Initials of first name(s) | N |
| Department | Ocular oncology Departement, Institut Curie, and UFR of Medicine University of Paris City |
| City | Paris |
| Country | France |
