Ocular Involvement in Relapsing Polychondritis (RPC): A case of recurring ptosis
Author: Arshi Kabir Baig
Base Hospital / Institution: Milton Keynes University Hospital
ePoster presentation
Abstract ID: 24-143
Purpose
We present a rare case of RPC presenting with intermittent ptosis and discuss the challenges involved in managing this complex condition given the limited evidence base.
Methods
We describe the management of a 53-year-old patient who presented to the eye department with recurrent now chronic left-sided ptosis and eyelid oedema. We conducted a literature review to identify various management options for ocular involvement in RPC.
Results
This patient had a history of intermittent ptosis for several years, which fluctuated between attacks. Systemic treatment in patients with moderate to severe presentation RPC commonly involves high-dose steroid therapy, anti-metabolite, or an immunosuppressant. Our patient had previously trialled corticosteroids and was already on steroid-sparing therapy. She provided a detailed photographic history showing development of an intermittent ptosis that resolved between attacks. After 17 years this became chronic with no resolution between flares of her RPC. Given the persistent stable ptosis, surgical intervention was deemed to be the best course of action. Bilateral upper lid anterior ptosis repair was performed and, a floppy tarsus was found intraoperatively which may we hypothesize could be due to the recurrent attacks over a prolonged period. The patient had an excellent postoperative outcome with an MRD1 of 4mm on either side.
Conclusion
This case showed a unique presentation of intermittent ptosis occurring with flare ups of RPC. For this patient, surgical ptosis repair was successful when carried out after the disease was in remission and the ptosis was stable.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ariel | Ong | Milton Keynes University Hospital |
| Jennifer | Doyle | Milton Keynes University Hospital |
| Zuzana | Sipkova | Milton Keynes University Hospital |
| Axelle | Rigaudy | Milton Keynes University Hospital |
