Antineutrophil Cytoplasmic Antibody-associated Optic Neuritis

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.