title: Ophthalmic presentation of giant cell arteritis in African-Americans.
abstract: PurposeTo determine the differences in the presentation of ophthalmic giant cell arteritis between African-Americans and Caucasians.MethodsThis was a multicenter retrospective case series comparing African-American patients with ophthalmic GCA to a previously published Caucasian cohort. Neuro-ophthalmic centers across the United States were contacted to provide data on African-American patients with biopsy-proven ophthalmic giant cell arteritis. The differences between African-American and Caucasian patients with respect to multiple variables, including age, sex, systemic and ophthalmic signs and symptoms, ocular ischemic lesions, and laboratory results were studied.ResultsThe Caucasian cohort was slightly older (mean=76.1 years) than the African-American cohort (mean=72.6 years, P=0.03), and there was no difference in sex distribution between the two cohorts. Headache, neck pain, and anemia were more frequent, while jaw claudication was less frequent in African-Americans (P<0.01, <0.001, 0.02, and 0.03 respectively). Acute vision loss was the most common presentation of giant cell arteritis in both groups, though it was less common in African-Americans (78 vs 98% of Caucasians, P<0.001). Eye pain was more common in African-Americans (28 vs 8% of Caucasians, P<0.01).ConclusionsThe presenting features of ophthalmic giant cell arteritis in African-Americans and Caucasians are not markedly different, although a few significant differences exist, including higher rates of headache, neck pain, anemia, and eye pain, and lower rates of jaw claudication and acute vision loss in African-Americans. Persons presenting with suspicious signs and symptoms should undergo evaluation for giant cell arteritis regardless of race.
authors.affiliation: Department of Ophthalmology, Jules Stein Eye Institute, Los Angeles, CA, USA.
authors.forename: S T
authors.initials: ST
authors.lastname: Garrity
authors.affiliation: Scheie Eye Institute, Department of Neurology and Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Pistilli
authors.affiliation: Department of Ophthalmology, University of Alabama, Birmingham, AL, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Vaphiades
authors.affiliation: Department of Ophthalmology, Howard University Hospital, Washington, DC, USA.
authors.forename: N Q
authors.initials: NQ
authors.lastname: Richards
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Subramanian
authors.affiliation: Bascom Palmer Eye Institute, Miami, FL, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Rosa
authors.affiliation: Bascom Palmer Eye Institute, Miami, FL, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Lam
authors.affiliation: Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Osborne
authors.affiliation: Scheie Eye Institute, Department of Neurology and Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: G T
authors.initials: GT
authors.lastname: Liu
authors.affiliation: Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Duncan
authors.affiliation: Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Shin
authors.affiliation: Department of Ophthalmology, Northwestern University, Chicago, IL, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Volpe
authors.affiliation: Scheie Eye Institute, Department of Neurology and Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Shindler
authors.affiliation: Department of Ophthalmology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Wills Eye Hospital, Philadelphia, PA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Moster
authors.affiliation: Scheie Eye Institute, Department of Neurology and Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Tracey
authors.affiliation: Bascom Palmer Eye Institute, Miami, FL, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Cuprill-Nilson
authors.affiliation: Scheie Eye Institute, Department of Neurology and Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Tamhankar
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D058447:Eye Pain / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013699:Temporal Arteries / Q000473:pathology; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology; D044465:White People / Q000706:statistics & numerical data