ANTERIOR ISCHEMIC OPTIC NEUROPATHY IN CHURG-STRAUSS-SYNDROME

A patient with a history of chronic rhinitis, sinusitis, and bronchial asthma developed a unilateral anterior ischemic optic neuropathy and a mild sensory motor neuropathy as the initial manifestation of system ic vasculitis. We made a probable diagnosis of Churg-Strauss syndrome. Fluorescein angiography showed delayed choroidal perfusion in both ey es. Marked eosinophilia, increased sedimentation rate, and elevated pe rinuclear anti-neutrophil cytoplasmic antibody and anti-myeloperoxidas e antibody titers were the main laboratory abnormalities that supporte d this diagnosis. Therapy with high-dose methylprednisolone and cyclop hosphamide may have preserved vision in the better seeing eye, improve d its choroidal circulation, and reversed the laboratory abnormalities except for a mild persistent eosinophilia. The neuropathy is graduall y improving.