Do temporal artery duplex ultrasound findings correlate with ophthalmic complications in giant cell arteritis?
OBJECTIVE
Ophthalmic complications are common in acute GCA. Do temporal artery ultrasound and clinical parameters correlate with the occurrence and severity of ophthalmic complications?


METHODS
The results of temporal artery ultrasound examinations are compared with the occurrence of anterior ischaemic optic neuropathy (AION), central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), diplopia and amaurosis fugax in 222 consecutive patients with newly diagnosed, active GCA.


RESULTS
Temporal artery ultrasound displayed vasculitic wall swelling (halo), stenoses and/or acute occlusions in 84% (58% in 67 large-vessel GCA patients and 95% in 155 patients without proximal arm vasculitis). Ophthalmic complications occurred in 64 (29%), AION in 30 (14%), CRAO in 7 (3%), BRAO in 2 (1%), amaurosis fugax in 16 (7%) and diplopia in 9 patients (4%). Ophthalmic complications were insignificantly more common if temporal artery ultrasound was positive (31 vs 17%; P = 0.11) as a greater number of patients without arm vasculitis showed eye involvement (34 vs 18%; P = 0.02). The number of pathological temporal artery segments, presence of stenoses or bilateral findings did not correlate with ophthalmic complications. Age >or= 72 yrs at diagnosis correlated with a higher incidence of ophthalmic complications.


CONCLUSIONS
Ophthalmic complications occurred less frequently if proximal arm vasculitis was present. Findings of temporal artery ultrasound did not correlate with eye complications.
Schmidt
Wolfgang A
WA
Medical Centre for Rheumatology Berlin-Buch, Berlin, Germany. schmidt.wa@t-online.de
Krause
Andreas
A
Schicke
Bernd
B
Kuchenbecker
Jörn
J
Gromnica-Ihle
Erika
E
D000368:Aged; D000369:Aged, 80 and over; D020757:Amaurosis Fugax / Q000150:complications / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D004172:Diplopia / Q000150:complications / Q000000981:diagnostic imaging; D005128:Eye Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000150:complications / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013699:Temporal Arteries / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color