Arteritic Anterior Ischaemic Optic Neuropathy and Chronic Cough as Presenting Features of Churg-Strauss Syndrome

Abstract

A 57-year-old man presented with severe, painless, stepwise vision loss in one eye over 24 hours. Fundus examination showed pallid optic disc oedema with cilioretinal artery occlusion. A retinal fluorescein angiogram showed patchy choroidal hypoperfusion of the affected eye, consistent with arteritic anterior ischaemic optic neuropathy (AION). Temporal artery biopsy revealed non-giant cell periarteritis. A systemic evaluation discovered a symptom complex of asthma, eosinophilia, and pulmonary infiltrates, suggesting Churg-Strauss syndrome. The patient was successfully treated with oral corticosteroid and metrotrexate, with stabilization of vision and improvement of systemic symptoms.

Keywords::

• anterior ischaemic optic neuropathy
• eosinophilic pneumonitis
• hypereosinophilia
• granulomatous periarteritis
• retinal fluorescein angiogram

ACKNOWLEDGEMENTS

The authors thank Drs. Nasreen Syed and Patricia Kirby for the interpretation of the temporal artery pathology.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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