Risk factors for early visual deterioration in temporal arteritis.
BACKGROUND
Despite corticosteroid treatment, patients with temporal arteritis may continue to lose vision. However, predictors of progressive visual loss are not known.


METHODS
We retrospectively reviewed 341 consecutive patients with suspected temporal arteritis who underwent temporal artery biopsy. 90 patients with biopsy proven temporal arteritis were included in our study.


RESULTS
Twenty-one patients (23%) experienced continuous visual symptoms despite steroid therapy and 14 among these suffered persistent visual deterioration. Based on univariate analysis, visual loss on presentation was associated with disc swelling and a history of hypertension. Risk factors for progressive visual loss included older age, elevated C reactive protein and disc swelling.


CONCLUSIONS
Although corticosteroid therapy improves the visual prognosis in temporal arteritis, steroids may not stop the progression of visual loss. Our study reliably establishes the risk factors for visual loss in this serious condition. Whether addressing these risk factors early in their presentation can alter the visual outcome remains unknown. Individual risk anticipating treatment regimens and strategies might improve the visual prognosis in temporal arteritis in the future.
Loddenkemper
Tobias
T
National Hospital for Neurology and Neurosurgery, London, UK. loddent@ccf.org
Sharma
Pankaj
P
Katzan
I
I
Plant
Gordon T
GT
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D013699:Temporal Arteries / Q000473:pathology; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014792:Visual Acuity / Q000187:drug effects
D000305:Adrenal Cortex Hormones