Recovery of visual function in patients with biopsy-proven giant cell arteritis.
OBJECTIVE
To assess the visual function of patients with giant cell arteritis (GCA) who had visual loss from either anterior ischemic optic neuropathy (AION) or central retinal artery occlusion and had a subsequent improvement in visual acuity after treatment with corticosteroids.


METHODS
Retrospective, observational case series.


METHODS
Thirty-two consecutive patients with biopsy-proven GCA treated at one institution between January 1992 and December 1997.


METHODS
Treatment with intravenous methylprednisolone 250 mg every 6 hours for 3 days, followed by oral prednisone 1 mg/kg daily for at least 4 weeks duration.


METHODS
The number of patients with an improvement in visual acuity after treatment with intravenous methylprednisolone; neuro-ophthalmic evaluation, including visual acuity, funduscopy, and visual field examination of these patients.


RESULTS
Improvement in visual acuity occurred in 5 of 39 eyes (13%) with visual loss from biopsy-proven GCA, and all 5 patients had AION. Despite the improvement of visual acuity in these 5 patients, perimetry revealed marked constriction of the visual field in each affected eye.


CONCLUSIONS
The prognosis for visual improvement in GCA is poor. Although an improvement in visual acuity occurred in 5 of our patients, marked constriction of the visual field was present in all of them.
Foroozan
Rod
R
Neuro-Ophthalmology Service, Jefferson Medical College, Thomas Jefferson University, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA 19107, USA.
Deramo
Vincent A
VA
Buono
Lawrence M
LM
Jayamanne
D Gerard R
DG
Sergott
Robert C
RC
Danesh-Meyer
Helen
H
Savino
Peter J
PJ
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008775:Methylprednisolone / Q000627:therapeutic use; D018917:Optic Neuropathy, Ischemic / Q000150:complications; D011241:Prednisone / Q000627:therapeutic use; D020127:Recovery of Function; D015356:Retinal Artery Occlusion / Q000150:complications; D012189:Retrospective Studies; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014794:Visual Fields
D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone