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Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases

Objective: Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This systematic review aimed to highlight the most common ophthalmic manifestations and to uncover their associations with antineutro...

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Autores principales: Moin, Kayvon Ahmad, Yeakle, Madeleine Marta, Parrill, Allison Margaret, Garofalo, Victoria Anne, Tsiyer, Allen Raphael, Bishev, Daniel, Gala, Dhir, Fogel, Joshua, Hatsis, Alexander James, Wickas, Tyler Daniel, Anand, Prachi, Morcos, Marcelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Romanian Society of Ophthalmology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591438/
https://www.ncbi.nlm.nih.gov/pubmed/37876507
http://dx.doi.org/10.22336/rjo.2023.38
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author Moin, Kayvon Ahmad
Yeakle, Madeleine Marta
Parrill, Allison Margaret
Garofalo, Victoria Anne
Tsiyer, Allen Raphael
Bishev, Daniel
Gala, Dhir
Fogel, Joshua
Hatsis, Alexander James
Wickas, Tyler Daniel
Anand, Prachi
Morcos, Marcelle
author_facet Moin, Kayvon Ahmad
Yeakle, Madeleine Marta
Parrill, Allison Margaret
Garofalo, Victoria Anne
Tsiyer, Allen Raphael
Bishev, Daniel
Gala, Dhir
Fogel, Joshua
Hatsis, Alexander James
Wickas, Tyler Daniel
Anand, Prachi
Morcos, Marcelle
author_sort Moin, Kayvon Ahmad
collection PubMed
description Objective: Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This systematic review aimed to highlight the most common ophthalmic manifestations and to uncover their associations with antineutrophil cytoplasmic antibody (ANCA) positivity and the presence of granulomas. Methods: A literature search of PubMed, Web of Science, and Scopus electronic databases was performed from journal inception to March 21, 2021, for case reports and a series of ophthalmic GPAs. Cytoplasmic-ANCA (c-ANCA), perinuclear-ANCA (p-ANCA), and granulomas were analyzed against many ophthalmic signs and symptoms. 306 patients with GPA were retrospectively studied. Results: Granulomas were present in 47.7% of our sample, c-ANCA in 59.2%, and p-ANCA in 10.8%. Scleritis was significantly associated with higher odds for c-ANCA positivity. Eye discharge, episcleritis, proptosis, and central nervous system (CNS) involvement were each significantly associated with lower odds for c-ANCA positivity. Orbital mass was significantly associated with lower odds for p-ANCA positivity. CNS involvement was significantly associated with higher odds for p-ANCA positivity (OR:3.08, 95% CI:1.02, 9.36, p=0.047) and orbital mass was significantly associated with lower odds for p-ANCA positivity. Conclusions: We recommend that clinicians should consider ocular or orbital GPA in patients presenting with non-specific eye complaints, such as vision impairment, orbital mass, or proptosis, and obtain further assessments to determine the possible presence of granuloma, c-ANCA, or p-ANCA. Abbreviations: GPA = Granulomatosis with Polyangiitis, ANCA = antineutrophil cytoplasmic antibody, c-ANCA = cytoplasmic-ANCA, p-ANCA = perinuclear-ANCA, CNS = central nervous system, AAVs = ANCA-associated vasculitides, SD = standard deviation, GU = genitourinary, ENT = ear nose and throat, OR = odds ratio, CI = confidence interval
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spelling pubmed-105914382023-10-24 Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases Moin, Kayvon Ahmad Yeakle, Madeleine Marta Parrill, Allison Margaret Garofalo, Victoria Anne Tsiyer, Allen Raphael Bishev, Daniel Gala, Dhir Fogel, Joshua Hatsis, Alexander James Wickas, Tyler Daniel Anand, Prachi Morcos, Marcelle Rom J Ophthalmol Reviews Objective: Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This systematic review aimed to highlight the most common ophthalmic manifestations and to uncover their associations with antineutrophil cytoplasmic antibody (ANCA) positivity and the presence of granulomas. Methods: A literature search of PubMed, Web of Science, and Scopus electronic databases was performed from journal inception to March 21, 2021, for case reports and a series of ophthalmic GPAs. Cytoplasmic-ANCA (c-ANCA), perinuclear-ANCA (p-ANCA), and granulomas were analyzed against many ophthalmic signs and symptoms. 306 patients with GPA were retrospectively studied. Results: Granulomas were present in 47.7% of our sample, c-ANCA in 59.2%, and p-ANCA in 10.8%. Scleritis was significantly associated with higher odds for c-ANCA positivity. Eye discharge, episcleritis, proptosis, and central nervous system (CNS) involvement were each significantly associated with lower odds for c-ANCA positivity. Orbital mass was significantly associated with lower odds for p-ANCA positivity. CNS involvement was significantly associated with higher odds for p-ANCA positivity (OR:3.08, 95% CI:1.02, 9.36, p=0.047) and orbital mass was significantly associated with lower odds for p-ANCA positivity. Conclusions: We recommend that clinicians should consider ocular or orbital GPA in patients presenting with non-specific eye complaints, such as vision impairment, orbital mass, or proptosis, and obtain further assessments to determine the possible presence of granuloma, c-ANCA, or p-ANCA. Abbreviations: GPA = Granulomatosis with Polyangiitis, ANCA = antineutrophil cytoplasmic antibody, c-ANCA = cytoplasmic-ANCA, p-ANCA = perinuclear-ANCA, CNS = central nervous system, AAVs = ANCA-associated vasculitides, SD = standard deviation, GU = genitourinary, ENT = ear nose and throat, OR = odds ratio, CI = confidence interval Romanian Society of Ophthalmology 2023 /pmc/articles/PMC10591438/ /pubmed/37876507 http://dx.doi.org/10.22336/rjo.2023.38 Text en #x00A9; The Authors.Romanian Society of Ophthalmology https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Moin, Kayvon Ahmad
Yeakle, Madeleine Marta
Parrill, Allison Margaret
Garofalo, Victoria Anne
Tsiyer, Allen Raphael
Bishev, Daniel
Gala, Dhir
Fogel, Joshua
Hatsis, Alexander James
Wickas, Tyler Daniel
Anand, Prachi
Morcos, Marcelle
Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title_full Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title_fullStr Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title_full_unstemmed Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title_short Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
title_sort ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591438/
https://www.ncbi.nlm.nih.gov/pubmed/37876507
http://dx.doi.org/10.22336/rjo.2023.38
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