Swollen disc secondary to systemic vasculitis in a young Taiwan Chinese female alleviated by interleukin-1 receptor antagonist
Purpose
To report a case with swollen disc secondary to systemic vasculitis alleviated by interleukin-1 receptor antagonist
Methods
case report
Results
A 14-year-old girl was referred to our clinics due to headache and intermittent foggy vision in the left eye for 6 days. Past history revealed intermittent episodes of dizziness and blackout in the past 6 months. However, brain CT showed negative findings in local hospital at that time. On examination, visual acuity (VA) was hand motion 30 cm over her right eye (OD) and 6/60 over her left eye (OS). Significant swollen disc and retinal vessel occlusion was observed in both eyes (OU). Fluorescein angiography (FA) demonstrated delayed filling of retinal vessels with diffuse microaneurysm over mid-peripheral retina, bilaterally. Magnetic resonance angiography showed remarkable stenosis of bilateral common carotid arteries and their branches. Under the impression of large vessel vasculitis secondary to Tagayasu’s arteritis, interleukin-1 receptor antagonist with Actemra was prescribed. The ocular and systemic symptoms relieved. The vision revealed improvement to counting finger 30cm (OD) and 6/15 (OS), respectively. However, the retinal arterioles progressively attenuated and the optic disc turned pale.
Conclusion
Swollen disc may be resulted from Tagayasu’s arteritis. Interleukin-1 receptor antagonist with Actemra is potential in the treatment of Tagayasu’s arteritis in Taiwan Chinese. Early diagnosis and prompt treatment are necessary.
Conflict of interest
No
Authors 1
Last name
TSAI
Initials of first name(s)
ML
Department
ophthalmology department, Taiwan Tzuchi General Hospital
City
New Taipei city
Country
Taiwan
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