European Journal of Rheumatology
Case based Review

Retinal vasculitis the first clue in the diagnosis of progressive hemifacial atrophy

1.

Department of Internal Medicine, John H Stroger Hospital of Cook County, Illinois, US

2.

Department of Rheumatology, Rush University Medical Center, Illinois, US

Eur J Rheumatol 2019; 6: 219-222
DOI: 10.5152/eurjrheum.2019.18100
Read: 208 Downloads: 58 Published: 16 October 2019

Retinal vasculitis is a sight-threatening condition that can occur as an isolated ocular disorder or in association with a number of systemic diseases. Parry–Romberg syndrome, also known as progressive hemifacial atrophy (PHA), is a rare disorder of unknown etiology characterized by unilateral facial atrophy and is associated with multiple ophthalmologic and neurologic manifestations. Here we report the case of a 17-year-old man with no prior diagnosis of PHA, who presented with a sudden onset of floaters and decreased vision in the right eye; he was found to have retinal vasculitis and uveitis in the right eye. Routine workup did not reveal the cause of retinal vasculitis. However, thorough physical examination demonstrated features of PHA overlapping with linear scleroderma en coup de sabre. The patient was started on treatment with systemic steroids with a later addition of methotrexate; he responded to treatment with considerable improvement in his symptoms and ophthalmologic examination.

 

Cite this article as: Vafa A, Gevorgyan O, De D, Hassan S. Retinal vasculitis the first clue in the diagnosis of progressive hemifacial atrophy. Eur J Rheumatol 2019; 6(4): 219-22.

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ISSN2147-9720 EISSN 2148-4279