Bilateral blindness in temporal arteritis with skip areas.
A 73-year-old woman received systemic corticosteroids for suspected temporal arteritis after blindness developed in the right eye during the previous day. Because a right temporal artery biopsy specimen was reported as normal, a diagnosis of arteriosclerotic ischemic optic neuropathy was made and the corticosteroid therapy was discontinued. Two weeks later the patient rapidly lost vision in her left eye. A left temporal artery biopsy specimen showed granulomatous arteritis adjacent to normal artery (skip area). Deeper sections of the original right temporal artery biopsy specimen also demonstrated a small focus of granulomatous arteritis adjacent to normal artery. In patients with suspected temporal arteritis, numerous step sections of a long segment of temporal artery should be examined; if the results are normal, the contralateral temporal artery should be studied. A nonspecific inflammatory reaction within or adjacent to the artery should alert the pathologist to the possible presence of a nearby focus of granulomatous arteritis.
D000368:Aged; D001766:Blindness / Q000209:etiology / Q000473:pathology*; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use
D011241:Prednisone