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Current concepts in granulomatosis poly angiitis and the eye

Current concepts in granulomatosis poly angiitis and the eye Purpose of reviewGranulomatosis with polyangiitis (GPA), a multisystem disease with diverse systemic and protean ocular manifestations. Its pathophysiology, spectrum of the ocular manifestations, changing paradigms in the diagnosis of the disease, recent updates in the treatment patterns are clinically relevant to the treating clinician. They are described in this review.Recent findings1.The ocular manifestations are not included in the updated diagnostic criteria of GPA. Hence, high index of suspicion is required when a clinician encounters eye as the first clinical presentation.2.The concentration of interleukin -32 and 6 are correlated to disease activity of GPA.3.Enzyme-linked immunoassay for antineutophilic antibodies are recommended over indirect immunofluorescence to detect the subtypes with clinical correlation. The false positivity of test results in tuberculosis needs to be ruled out.4.Both rituximab and cyclophosphamide are equally considered as a first line of therapy of GPA in the induction phase as per randomized studies. During the continuation phase, switch over to methotrexate and mycophenolate can be considered.SummaryThe changing trends in the diagnosis, treatment can be adapted to real time clinical practice to provide the best quality of life to patients with GPA. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in Ophthalmology Wolters Kluwer Health

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References (80)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
1040-8738
eISSN
1531-7021
DOI
10.1097/icu.0000000000000906
Publisher site
See Article on Publisher Site

Abstract

Purpose of reviewGranulomatosis with polyangiitis (GPA), a multisystem disease with diverse systemic and protean ocular manifestations. Its pathophysiology, spectrum of the ocular manifestations, changing paradigms in the diagnosis of the disease, recent updates in the treatment patterns are clinically relevant to the treating clinician. They are described in this review.Recent findings1.The ocular manifestations are not included in the updated diagnostic criteria of GPA. Hence, high index of suspicion is required when a clinician encounters eye as the first clinical presentation.2.The concentration of interleukin -32 and 6 are correlated to disease activity of GPA.3.Enzyme-linked immunoassay for antineutophilic antibodies are recommended over indirect immunofluorescence to detect the subtypes with clinical correlation. The false positivity of test results in tuberculosis needs to be ruled out.4.Both rituximab and cyclophosphamide are equally considered as a first line of therapy of GPA in the induction phase as per randomized studies. During the continuation phase, switch over to methotrexate and mycophenolate can be considered.SummaryThe changing trends in the diagnosis, treatment can be adapted to real time clinical practice to provide the best quality of life to patients with GPA.

Journal

Current Opinion in OphthalmologyWolters Kluwer Health

Published: Nov 21, 2022

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