Temporal artery biopsy in the management of giant cell arteritis with neuro-ophthalmic complications

The risk of bilateral ocular involvement in GCA is estimated at 10-50%, depending on whether steroids have been given, and the interval between involvement of the two eyes is measured in days or weeks. 10 In our experience of 21 consecutive patients with arteritic AION, 10 developed visual loss in t...

Full description

Saved in:
Bibliographic Details
Published in:British journal of ophthalmology 2001-10, Vol.85 (10), p.1248-1251
Main Authors: Riordan-Eva, Paul, Landau, Klara, O'Day, Justin
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anti-Inflammatory Agents - therapeutic use
Biological and medical sciences
Biopsy
Cerebral arteries
Controversies in Ophthalmology
Diagnosis
Diagnosis, Differential
Female
Giant cell arteritis
Giant Cell Arteritis - drug therapy
Giant Cell Arteritis - pathology
Humans
Inflammation
Medical imaging
Medical sciences
Methods
Occult sciences
Predictive Value of Tests
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Steroids
Surgery
temporal artery biopsy
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The risk of bilateral ocular involvement in GCA is estimated at 10-50%, depending on whether steroids have been given, and the interval between involvement of the two eyes is measured in days or weeks. 10 In our experience of 21 consecutive patients with arteritic AION, 10 developed visual loss in the second eye mainly because of delayed diagnosis, but occasionally due to rapid reduction of steroid dose in the course of the disease. 11 When systemic side effects arise in a patient who lost vision in one eye from GCA, the general physician may be inclined to reduce or stop treatment, and is more ready to do so if no initial temporal artery biopsy was performed. There is up to 5% chance of a positive contralateral biopsy when the first biopsy is negative (see above). [...]two normal temporal artery biopsies probably do exclude giant cell arteritis, as long as both specimens are of adequate length (more than 20 mm) and have undergone careful examination of serial sections, and the pathologist is sensitive to atypical features if the biopsies have been taken more than 2 weeks after institution of systemic steroid therapy. 36-39 In such cases, clinical features will determine the pattern of investigation, such as whether neuroimaging is required.
ISSN:0007-1161
1468-2079
DOI:10.1136/bjo.85.10.1248