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Ophthalmic Images
July 14, 2016

Ultra-Widefield Imaging in Granulomatosis With Polyangiitis

Author Affiliations
  • 1Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan
JAMA Ophthalmol. 2016;134(7):e160034. doi:10.1001/jamaophthalmol.2016.0034

A man in his 40s with blurry vision in both eyes presented with headaches, arthritis, anorexia, and weight loss. Visual acuity was counting fingers OD and hand motions OS. Examination revealed a flat nasal bridge, anterior chamber cells, and vitreous cells (in addition to the posterior segment findings described in the Figure legend). Workup revealed antineutrophil cytoplasmic antibody (proteinase 3 antineutrophil cytoplasmic antibody) positivity, consistent with granulomatosis with polyangiitis. Treatment with systemic steroids was initiated and transitioned to methotrexate, cyclosporine, and infliximab. The systemic symptoms and ophthalmic findings improved.