Granulomatosis With Polyangiitis in a Young Lady: Challenges in Achieving Remission.

Granulomatosis with polyangiitis (GPA) is a subtype of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) that commonly requires aggressive immunosuppression to achieve remission. We present a case of a young Malay lady with recurrent episodes of ANCA-positive nodular anterior scleritis who responded poorly to topical and systemic corticosteroids and relapsed while on methotrexate. A year later, she had epistaxis, and a sino-nasal biopsy confirmed granulomatous vasculitis.

Vision Loss as a Presenting Symptom of Vitamin B12 Deficiency.

Nutritional optic neuropathy is a rare and often overlooked factor leading to bilateral, symmetrical, and gradual visual impairment. This condition falls within the category of metabolic neuropathies. We documented a case involving bilateral nutritional optic neuropathy attributed to pancytopenia associated with vitamin B12 deficiency.

Bilateral Choroidal Osteoma in a Teenage Girl With Chronic Posterior Scleritis.

A 14-year-old girl with bilateral chronic posterior scleritis was referred to us for poor control of ocular inflammation. There was an incidental finding of choroidal osteoma bilaterally whereby the choroidal mass in her right eye demonstrated a significant tumor growth in a short duration of two months. The right eye choroidal tumor was orangy in color with a well-defined margin, two-disc diameter in size, and located at the macula encroaching the fovea.