Correlation of clinical profile and specific histopathological features of temporal artery biopsies.
BACKGROUND
This study sought to correlate the clinical features of patients with giant cell arteritis (GCA) who present with ophthalmic symptoms and signs, with 2 specific histopathological findings-the presence of giant cells and arterial wall neoangiogenesis. The goal was to assess if these pathological features might be useful in guiding the approach to patient management.


METHODS
Medical charts were retrospectively reviewed from 58 patients who underwent a temporal artery biopsy at a single institution. Detailed information was collected about the clinical presentation and course, with an emphasis on visual function. Histopathological and immunohistochemical techniques were used to examine temporal artery biopsies for evidence of inflammation. Correlations were made between the clinical data and the presence of giant cells and neoangiogenesis.


RESULTS
Twenty-one (34%) biopsies were positive for inflammation consistent with GCA. Although the percentage of positive biopsies with giant cells was high, neither the presence of giant cells nor neoangiogenesis was predictive of a patient's presenting visual symptoms, severity and bilaterality of vision loss, other ophthalmic manifestations of GCA, presence of headache or jaw claudication, or erythrocyte sedimentation rate. Giant cells were more common in patients with recent weight loss. Immunohistochemistry confirmed diagnoses but did not alter the clinical course or treatment plan.


CONCLUSIONS
There was no correlation between the clinical, specifically visual, features of GCA and the presence or absence of giant cells or neoangiogenesis in temporal artery biopsy specimens. Although the presence of neoangiogenesis may be important in the pathogenesis of GCA, our study showed no correlation between this finding and the clinical course.
Department of Ophthalmology (RCS, ALG, JFR), Harvard Medical School, Boston, Massachusetts; Division of Neuro-Ophthalmology (RCS, JFR), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and Division of Ocular Pathology (RCS), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Rebecca C
RC
Stacy
Aubrey L
AL
Gilbert
Joseph F
JF
Rizzo
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D015703:Antigens, CD; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013223:Statistics as Topic; D013699:Temporal Arteries / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D015703:Antigens, CD