Abstract
P 034
Necrotizing scleritis in Wegener’s granulomatosis
Andrei Nestler, Elizabeth Scharfenberg, Ina Sterker, Petra Meier
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig, Leipzig
Objective
Wegener´s granulomatosis is a generalized necrotizing granulomatous vasculitis with multiple possible manifestations in the eye. One of them, necrotizing scleritis, is a serious eye threatening disease.
Methods
Case report of a 56-year-old patient with known Wegener's granulomatosis who was referred to our hospital because of a necrotizing scleritis. Besides the systemic immunosuppressive therapy, surgical intervention was necessary.
Results
Despite systemic immunosuppressive therapy with cyclophosphamide and prednisolone the local scleral necrosis deteriorated. Due to impending perforation, autologous sclera was transplanted. Six weeks later the transplanted scleral patch melt down as well. We chose to cover the defect with an corneal transplant. The situation has been stable now for over a year.
Conclusions
Therapy of Wegener´s granulomatosis is primarily conservative. The prognosis of surgical intervention is poor in necrotizing scleritis. Nevertheless in individual case when the systemic immunosuppressive therapy is insufficient, a surgical approach may be reasonable to save the eye.
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