AN ILLUSTRATED RARE CASE OF ANTERIOR SEGMENT MANIFESTATIONS OF WEGNER GRANULOMATOSIS

Granulomatosis with polyangiitis (GPA), previously known as Wegener Granulomatosis, is an autoimmune disorder characterized by granulomatous necrotizing vasculitis that typically affects small and/or medium sized blood vessels in the orbit, respiratory tract (sinuses, nose, throat, lungs), and kidneys. Ocular manifestations can inculde every structure of the eye ranging from the orbit and eyelids, to the retina and optic nerve. 

Ophthalmology department, Mohammed VI university hospital, Oujda, Morocco

A 63 Y.O woman presenting a severe form of anterior ocular features related to GPA

we report the case of a 63 Y.O woman , with medical history of treated pulmobnary tuberculosis , addmitted for headeaches , febrile dry cough evolving since 6 months with wieght loss. she presented a decreased VA with sensation of foreign body in both eyes. Ophthalmological examination showed a VA of HM in RE and 0.2 in LE , with in both eyes an extremly thinned sclera mimicking scleromalacia, multiples corneal opacities with neovascularisation. she also presented multiples lung micronodules , a chronic sinustis. P-ANCA was positif with tuberculosis screening negatif. Biospy showed a granuloma without necrosis. She recevied local and systemic antiinflammatory treatement with mild improvement and discussion of using immunosuppressant agents.

our case do illustrates a rare entity of a systemic disease manifestations , that may lead to be more inclusive of this features in the diagnosis criterias of the disease.