Pseudotumoral lesion of ciliary body in a patient with Polyarteritis Nodosa
Purpose
To report a case of inflammatory ciliary body lesion in Polyarteritis Nodosa
Methods
A 64-year-old patient was referred for evaluation of ciliary body mass. He reported decreased visual acuity of 3 months and lower limb skin nodular lesions, treated with oral corticosteroids. He had a 10-year history of polyarteritis nodosa (under Azathioprine 100 mg/d and meprednisone 8 mg/d) and secondary arterial hypertension. Best corrected visual acuity was OD 20/200 and OS 20/25. Biomicroscopy showed iris protrusion narrowing iridocorneal angle in lower temporal sector in OD, posterior synechiae, cilioconjunctival injection and cataract. We performed optical coherence tomography, ultrabiomicroscopy, orbital thoracic abdominopelvian computed tomography (CT) and laboratory was requested to rule out infection.
Results
Elevation of anterior iris profile in right eye was observed at 7-8 hour and cystoid macular edema by OCT. An heterogeneous solid lesion in ciliary body with poorly defined posterior margin was detected by UBM, compromising posterior iris. Chest, abdominal CT, and laboratory were unremarkable. Fine needle aspiration biopsy showed scant inflammation signs, ruling out atypia. Prednisolone acetate was added and methylprednisolone raised to 40 mg/d. A marked reduction in lesion size and better delimitation was observed. Patient remains stable after 9 months on Azathioprine.
Conclusion
Ophtalmic manifestations are reported in 10 to 20% of patients with PAN. To our knowledge this is the first report of a nodular ciliary body lesion as ocular manifestation of this illness, mimiking an intraocular tumor.
Conflict of interest
No
Authors 1
Last name
GARCIA
Initials of first name(s)
MM
Department
Uveitis
City
Ciudad Autónoma de Buenos Aires
Country
Argentina
Authors 2
Last name
Gentile
Initials of first name(s)
MC
Department
Ocular Oncology
City
Ciudad Autónoma de Buenos Aires
Country
Argentina
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