Late ipsilateral recurrence of ischemic optic neuropathy in giant cell arteritis.
A patient with arteriosclerosis, diabetes mellitus, and giant cell arteritis (GCA) treated continuously with low-dose prednisone developed anterior ischemic optic neuropathy (AION) at 5 and 13 months after clinical diagnosis of GCA. At the time of late recurrent AION, there were no systemic symptoms or elevations in acute phase reactants to signal active arteritis, yet temporal artery biopsy disclosed dramatic inflammation, forcing the presumption that the infarct was arteritic. Recurrent systemic symptoms and elevation of acute phase reactants are not reliable warning signs of reactivated GCA. In patients at high risk for corticosteroid complications, late biopsy may be a reasonable guide to corticosteroid weaning.
Kim
Nancy
N
Departments of Ophthalmology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Trobe
Jonathan D
JD
Flint
Andrew
A
Keoleian
Gary
G
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005654:Fundus Oculi; D013700:Giant Cell Arteritis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D018917:Optic Neuropathy, Ischemic / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D011241:Prednisone / Q000008:administration & dosage; D055502:Secondary Prevention; D013699:Temporal Arteries / Q000473:pathology; D017211:Treatment Failure; D014792:Visual Acuity; D014794:Visual Fields
D000893:Anti-Inflammatory Agents; D011241:Prednisone