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Management of Giant Cell Arteritis to Prevent Visual Loss

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Ischemic Optic Neuropathies

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Abstract

As has been emphasized in earlier chapters, the most dreaded complication of giant cell arteritis (GCA) is permanent visual loss in one or both eyes – and fear of visual loss is exceeded only by fear of death. If GCA is diagnosed early and treated immediately, aggressively and adequately with systemic corticosteroids, blindness is entirely preventable; that makes GCA the prime ophthalmic emergency. A study [1] further emphasized that fact, when it found that a high proportion of patients with permanent visual loss had had a delayed diagnosis and treatment; in that study 35% had experienced systemic symptoms for an average of 10.8 months before visual loss and 65% had had premonitory visual symptoms for an average of 8.5 days. This obviously raises two critical issues about the management of GCA: (1) how to establish an early and a definite diagnosis of GCA? and (2) what is the proper treatment to prevent blindness? There is a voluminous literature on both these topics; however, there is still a good deal of controversy on both issues [2].

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  1. Department of Ophthalmology and Visual Science, University of Iowa Hospital and Clinics College of Medicine, Hawkins Dr. 200, Iowa City, IA, 52242–1091, USA

    Dr. Sohan Singh Hayreh

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Hayreh, S.S. (2011). Management of Giant Cell Arteritis to Prevent Visual Loss. In: Ischemic Optic Neuropathies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11852-4_13

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