Ocular ichemia syndrome - a malignant course of giant cell arteritis.
OBJECTIVE
To call attention to a malignant course of ocular ischemic syndrome in patients with giant cell arteritis (GCA). METHODS/PATIENT: A 84-year-old woman developed severe headache for about 3 (1/2) months prior to myocardial infarction and visual disturbances.


RESULTS
An anterior ischemic optic neuropathy (AION) in the right eye with a distinct reduction in visual acuity was found. The retina revealed several cotton-wool spots in both eyes. Serologic examinations showed inflammatory signs. Despite treatment with prednisolone, eye pressure decreased to 2 mm Hg in the right eye and 4 mm Hg in the left eye in a few days. An ischemic iritis developed in the right eye. Visual acuity worsened to detection of hand motions in the right eye and to 0.1 in the left eye. Approximately 8 (1/2) months after her initial headache, a biopsy was carried out. The patient was treated continuously with corticosteroids. Histology of the superficial temporal artery indicated inflammatory cells in the vessel wall. - The patients daughter developed symptoms of GCA at the age of 54 years.


CONCLUSIONS
An ocular ischemic syndrome points to a malignant course of the disease. A cardiac infarction can develop in GCA. A biopsy of the temporal artery can reveal inflammatory changes even after 8 (1/2) months.
Schmidt
Dieter
D
Department of Ophthalmology, University of Freiburg, Germany. Dieter.Schmidt@uniklinik-freiburg.de
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000150:complications; D009203:Myocardial Infarction / Q000150:complications; D018917:Optic Neuropathy, Ischemic / Q000209:etiology*; D012607:Scotoma / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields