Clinical features in patients with permanent visual loss due to biopsy-proven giant cell arteritis.
The objective was to determine associated clinical findings in patients with visual loss due to giant cell arteritis (GCA) by means of a record review of 146 patients with biopsy-proven GCA. Twenty-three (15.75%) patients had lost vision. All of these patients complained of classical GCA cranial symptoms for an average of 1.3 months, 34.8% had an apparent isolated polymyalgia rheumatica for an average of 10.8 months and 65.2% had premonitory visual symptoms before visual loss for an average of 8.5 days. A clear delay in diagnosis and treatment was present in 15 patients (65.2%) who complained of at least two classical cranial symptoms for longer than 3 weeks and/or who had presented premonitory visual symptoms for longer than 72 h before blindness. Two additional patients lost vision while receiving standard steroid therapy. In conclusion, a high proportion of patients with permanent visual loss have a delayed diagnosis and treatment. A wider recognition of the disease would potentially reduce the prevalence of irreversible visual loss among GCA patients.
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Department of Internal Medicine, Hospital Clinic i Provincial, University of Barcelona, Spain.
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Coll-Vinent
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López-Soto
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Grau
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JM
D001706:Biopsy; D001766:Blindness / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000175:diagnosis; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011111:Polymyalgia Rheumatica / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D013699:Temporal Arteries / Q000473:pathology*; D014785:Vision, Ocular / Q000502:physiology
D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone