Document Detail


An occult case of giant cell arteritis presenting with combined anterior ischemic optic neuropathy and cilioretinal artery occlusion.
MedLine Citation:
PMID:  15590540     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 61-year-old female presented with a moderate decrease in vision in the left eye. The patient denied any other ocular or systemic symptoms related to giant cell arteritis. Visual acuity was 20/50 in the left eye with a 2+ relative afferent pupillary defect and markedly abnormal color vision. Dilated fundus examination and flourescein angiography revealed optic disc edema as well as a cilioretinal artery occlusion. Erythrocyte sedimentation rate was only slightly elevated. Subsequent biopsy of the superficial temporal artery confirmed the diagnosis of giant cell arteritis. Cilioretinal arteries are anatomical variants derived from the short posterior ciliary arteries. Arteritic anterior ischemic optic neuropathy typically results from thrombotic occlusion of the short posterior ciliary arteries. Consequently, arteritic occlusion of the short posterior ciliary arteries can result in concomitant occlusion of the cilioretinal artery. This case highlights the situation where clinical symptoms were not suspicious for giant cell arteritis but the presence of an anterior ischemic optic neuropathy and a cilioretinal artery occlusion was virtually pathognomonic for giant cell arteritis.
Authors:
John M Galasso; Walter M Jay
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Seminars in ophthalmology     Volume:  19     ISSN:  0882-0538     ISO Abbreviation:  Semin Ophthalmol     Publication Date:    2004 Sep-Dec
Date Detail:
Created Date:  2004-12-13     Completed Date:  2005-03-07     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  8610759     Medline TA:  Semin Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  75-7     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois 60153, USA. jgalasso@lumc.edu
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / complications*,  diagnosis,  drug therapy
Biopsy
Ciliary Arteries*
Female
Fluorescein Angiography
Giant Cell Arteritis / diagnosis,  drug therapy,  etiology*
Glucocorticoids / therapeutic use
Humans
Middle Aged
Optic Neuropathy, Ischemic / complications*,  diagnosis,  drug therapy
Papilledema / complications,  diagnosis,  drug therapy
Prednisone / therapeutic use
Retinal Artery Occlusion / complications*,  diagnosis,  drug therapy
Temporal Arteries
Chemical
Reg. No./Substance:
0/Glucocorticoids; 53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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