Recovery of visual function in patients with biopsy-proven giant cell arteritis.

Abstract

OBJECTIVE:

To assess the visual function of patients with giant cell arteritis (GCA) who had visual loss from either anterior ischemic optic neuropathy (AION) or central retinal artery occlusion and had a subsequent improvement in visual acuity after treatment with corticosteroids.

DESIGN:

Retrospective, observational case series.

PARTICIPANTS:

Thirty-two consecutive patients with biopsy-proven GCA treated at one institution between January 1992 and December 1997.

INTERVENTION:

Treatment with intravenous methylprednisolone 250 mg every 6 hours for 3 days, followed by oral prednisone 1 mg/kg daily for at least 4 weeks duration.

MAIN OUTCOME MEASURES:

The number of patients with an improvement in visual acuity after treatment with intravenous methylprednisolone; neuro-ophthalmic evaluation, including visual acuity, funduscopy, and visual field examination of these patients.

RESULTS:

Improvement in visual acuity occurred in 5 of 39 eyes (13%) with visual loss from biopsy-proven GCA, and all 5 patients had AION. Despite the improvement of visual acuity in these 5 patients, perimetry revealed marked constriction of the visual field in each affected eye.

CONCLUSIONS:

The prognosis for visual improvement in GCA is poor. Although an improvement in visual acuity occurred in 5 of our patients, marked constriction of the visual field was present in all of them.

• Authors: Rod Foroozan, Vincent A Deramo, Lawrence M Buono, D Gerard R Jayamanne, Robert C Sergott, Helen Danesh-Meyer, Peter J Savino
• Journal: Ophthalmology (Ophthalmology) Vol. 110 Issue 3 Pg. 539-42 (Mar 2003) ISSN: 0161-6420 [Print] United States
• PMID: 12623817 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Glucocorticoids
• Prednisone
• Methylprednisolone

Topics

• Aged
• Aged, 80 and over
• Biopsy
• Female
• Giant Cell Arteritis (complications, drug therapy, physiopathology)
• Glucocorticoids (therapeutic use)
• Humans
• Infusions, Intravenous
• Methylprednisolone (therapeutic use)
• Optic Neuropathy, Ischemic (complications)
• Prednisone (therapeutic use)
• Recovery of Function
• Retinal Artery Occlusion (complications)
• Retrospective Studies
• Vision Disorders (drug therapy, etiology, physiopathology)
• Visual Acuity (physiology)
• Visual Field Tests
• Visual Fields