Ocular manifestations of cryoglobulinemia: a reappraisal

Background/Objectives To describe frequency and type of ocular manifestations in patients with cryoglobulinemic vasculitis (CV), as well as management approaches and outcomes. Subjects/Methods This was a retrospective, observational, cohort study of patients who were diagnosed with CV at a single ce...

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Bibliographic Details
Published in:Eye (London) 2024-02, Vol.38 (3), p.585-593
Main Authors: Dammacco, Rosanna, Cimino, Luca, De Simone, Luca, Alessio, Giovanni, Dammacco, Franco
Format: Article
Language:English
Subjects:
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Acuity
Antiviral agents
Antiviral Agents - therapeutic use
Autoimmune diseases
Cohort analysis
Cohort Studies
Cryoglobulinemia
Cryoglobulinemia - complications
Cryoglobulinemia - diagnosis
Cryoglobulinemia - drug therapy
Cryoglobulins
Cryoglobulins - therapeutic use
Disease
Eye diseases
Hepatitis C
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Humans
Immunoglobulins
Immunology
Keratitis
Laboratory Medicine
Lubricants
Lymphoma
Medicine
Medicine & Public Health
Ophthalmology
Patients
Pharmaceutical Sciences/Technology
Retinopathy
Ribavirin
Scleritis
Sjogren's syndrome
Surgery
Surgical Oncology
Vasculitis
Vasculitis - drug therapy
Visual acuity
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Description
Summary:Background/Objectives To describe frequency and type of ocular manifestations in patients with cryoglobulinemic vasculitis (CV), as well as management approaches and outcomes. Subjects/Methods This was a retrospective, observational, cohort study of patients who were diagnosed with CV at a single center and regularly underwent a comprehensive ocular assessment. Results Ophthalmologic manifestations were recorded in 16 patients (28%). The diagnoses included dry eye disease and primary Sjögren syndrome in 5 and 2 patients, respectively; peripheral ulcerative keratitis and anterior scleritis in 1 patient each; hyperviscosity syndrome and hypertensive retinopathy in 2 patients each; and Purtscher- like retinopathy in 3 patients. Twelve patients (75%) were anti-HCV/HCV RNA-positive, 11 of whom achieved a sustained virologic response (SVR) following treatment with interferon-α2b plus ribavirin or direct-acting antivirals. All patients were treated with ocular lubricants. Systemic therapeutic measures, including glucocorticoids, immunosuppressive and biologic agents, induced the disappearance or ≥50% reduction of cryoglobulins and major signs of vasculitis in 11 patients (68.7%). In the remaining 5 patients (31.3%), cryoglobulins and CV manifestations remained unchanged or decreased by
ISSN:0950-222X
1476-5454
DOI:10.1038/s41433-023-02738-y