J Korean Ophthalmol Soc.  2020 Oct;61(10):1246-1250. 10.3341/jkos.2020.61.10.1246.

Antineutrophil Cytoplasmic Antibody-associated Optic Neuritis

• Lee J
• Baek J

• KMID: 2511260
• DOI: http://doi.org/10.3341/jkos.2020.61.10.1246

Abstract

Purpose
We report a case of antineutrophil cytoplasmic antibody (ANCA)-associated optic neuritis with glomerulonephritis.
Case summary
A 66-year-old male with a history of acute kidney injury presented with decreased visual acuity in both eyes. His best-corrected visual acuity (BCVA) was 0.15 in the right eye and 0.6 in the left eye. Both eyes showed optic disc swelling and Ishihara’s tests were 1/17. He was treated with intravenous methylprednisolone for 3 days to treat presumed bilateral optic neuritis. In follow-up, anti-myeloperoxidase antibody (anti-MPO antibody, p-ANCA) was positive at 32.0 IU/mL and ANCA-associated chronic sclerosing glomerulonephritis was found in the left kidney biopsy. He is currently being followed-up on oral steroids in the outpatient clinic. Kidney function improved immediately after high-dose steroid therapy. After 3 months of treatment, optic disc swelling resolved. On the other hand, there was minimal improvement in visual acuity.
Conclusions
In ANCA-associated optic neuritis with glomerulonephritis, both optic disc swelling and kidney function improved with steroid therapy. On the other hand, there was only a small improvement in visual acuity.

Keyword

Antineutrophil cytoplasmic antibody; Autoimmune optic neuropathy; Glomerulonephritis; Optic neuritis