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2016 ; 2
(ä): 26-29
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Vasculitic central retinal vein occlusion: The presenting sign of seronegative
rheumatoid arthritis
#MMPMID29503893
Trese MGJ
; Yonekawa Y
; Thomas BJ
; Randhawa S
Am J Ophthalmol Case Rep
2016[Jul]; 2
(ä): 26-29
PMID29503893
show ga
PURPOSE: To report the case of a patient who presented with a vasculitic central
retinal vein occlusion (CRVO), which was the result of an undiagnosed systemic
inflammatory condition, seronegative rheumatoid arthritis (RA). OBSERVATIONS: The
patient presented with reduced vision in the left eye and polyarthralgia.
Fundoscopic examination revealed a central retinal vein occlusion (CRVO) with
concurrent evidence of vasculitis. Work-up for polyarthralgia included
comprehensive serologic testing for connective tissue disease, including
Vectra(®) disease activity (DA) testing. Results of these studies confirmed the
diagnosis of seronegative rheumatoid arthritis (RA). Systemic steroid therapy was
initiated with subsequent anatomic and visual improvement. CONCLUSIONS AND
IMPORTANCE: We hypothesize that the systemic inflammation-a hallmark of RA-led to
the development of a vasculitic CRVO and, thus, the retinal manifestations served
as the disease marker that prompted thorough work-up of the patient's disease,
even in the face of initial seronegativity. This case serves as a reminder that,
in the setting of CRVO and polyarthralgia, systemic inflammatory conditions must
be considered as the underlying etiology. Further, this case report highlights
our evolving understanding of the role that serologic markers play in the
diagnosis and monitoring of RA.