Choroidal ischemia as one cardinal sign in giant cell arteritis
Abstract Purpose To describe chorioretinal signs in a case series of Giant Cell Arteritis (GCA). Methods This is a multicenter retrospective observational case series with GCA that presented with a headache and an abrupt, unilateral loss in vision. Workup included temporal artery biopsies, intraveno...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | International Journal of Retina and Vitreous |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40942-022-00422-z |
| _version_ | 1818016693762392064 |
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| author | Antonio M. B. Casella Ahmad M. Mansour Souza EC Rodrigo B. do Prado Rodrigo Meirelles Keye Wong Salma Yassine Mário Luiz R. Monteiro |
| author_facet | Antonio M. B. Casella Ahmad M. Mansour Souza EC Rodrigo B. do Prado Rodrigo Meirelles Keye Wong Salma Yassine Mário Luiz R. Monteiro |
| author_sort | Antonio M. B. Casella |
| collection | DOAJ |
| description | Abstract Purpose To describe chorioretinal signs in a case series of Giant Cell Arteritis (GCA). Methods This is a multicenter retrospective observational case series with GCA that presented with a headache and an abrupt, unilateral loss in vision. Workup included temporal artery biopsies, intravenous fluorescein angiography, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), blood levels of erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results There are a total of 8 GCA instances presented. Average age was 74.5. (Range 68–83 years). The patients reported that one eye's visual loss had suddenly started, along with a fresh headache and other systemic symptoms. Eight patients exhibited choroidal ischemia, five paracentral acute middle maculopathy (PAMM) lesions, five cotton wool spots, four anterior ischemic optic neuropathy, and one central retinal arterial occlusion at the time of presentation. The average ESR at presentation was 68 mm/hr (range 4–110), and 4/6 individuals had a significant increase. The mean CRP level was 6.2 mg/dL (range 2.0–15.4), and the level was always over the normal range. All patients' temporal artery biopsies were positive. Conclusion Alongside PAMM lesions, cotton wool spots, anterior ischemic optic neuropathy, and central retinal artery occlusion, choroidal ischemia is a key angiographic indicator in the diagnosis of GCA. It may be crucial to recognize these typical ischemic chorioretinal signs while diagnosing GCA. |
| first_indexed | 2024-04-14T07:16:11Z |
| format | Article |
| id | doaj.art-99d462e048c74dea84edaa8d38cc0792 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-04-14T07:16:11Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-99d462e048c74dea84edaa8d38cc07922022-12-22T02:06:18ZengBMCInternational Journal of Retina and Vitreous2056-99202022-09-018111110.1186/s40942-022-00422-zChoroidal ischemia as one cardinal sign in giant cell arteritisAntonio M. B. Casella0Ahmad M. Mansour1Souza EC2Rodrigo B. do Prado3Rodrigo Meirelles4Keye Wong5Salma Yassine6Mário Luiz R. Monteiro7Department of Surgery, Health Sciences Center, Londrina State UniversityDepartment of Ophthalmology, American University of BeirutDivision of Ophthalmology, University of São PauloDepartment of Surgery, Health Sciences Center, Londrina State UniversityPiracicaba Ophthalmological InstituteRetina Associates of SarasotaDepartment of Ophthalmology, University of MinnesotaDivision of Ophthalmology, University of São PauloAbstract Purpose To describe chorioretinal signs in a case series of Giant Cell Arteritis (GCA). Methods This is a multicenter retrospective observational case series with GCA that presented with a headache and an abrupt, unilateral loss in vision. Workup included temporal artery biopsies, intravenous fluorescein angiography, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), blood levels of erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results There are a total of 8 GCA instances presented. Average age was 74.5. (Range 68–83 years). The patients reported that one eye's visual loss had suddenly started, along with a fresh headache and other systemic symptoms. Eight patients exhibited choroidal ischemia, five paracentral acute middle maculopathy (PAMM) lesions, five cotton wool spots, four anterior ischemic optic neuropathy, and one central retinal arterial occlusion at the time of presentation. The average ESR at presentation was 68 mm/hr (range 4–110), and 4/6 individuals had a significant increase. The mean CRP level was 6.2 mg/dL (range 2.0–15.4), and the level was always over the normal range. All patients' temporal artery biopsies were positive. Conclusion Alongside PAMM lesions, cotton wool spots, anterior ischemic optic neuropathy, and central retinal artery occlusion, choroidal ischemia is a key angiographic indicator in the diagnosis of GCA. It may be crucial to recognize these typical ischemic chorioretinal signs while diagnosing GCA.https://doi.org/10.1186/s40942-022-00422-zGiant cell arteritisChoroidal hypoperfusionParacentral acute middle maculopathyFluorescein angiographyOCTAArteritic anterior ischemic optic neuropathy |
| spellingShingle | Antonio M. B. Casella Ahmad M. Mansour Souza EC Rodrigo B. do Prado Rodrigo Meirelles Keye Wong Salma Yassine Mário Luiz R. Monteiro Choroidal ischemia as one cardinal sign in giant cell arteritis International Journal of Retina and Vitreous Giant cell arteritis Choroidal hypoperfusion Paracentral acute middle maculopathy Fluorescein angiography OCTA Arteritic anterior ischemic optic neuropathy |
| title | Choroidal ischemia as one cardinal sign in giant cell arteritis |
| title_full | Choroidal ischemia as one cardinal sign in giant cell arteritis |
| title_fullStr | Choroidal ischemia as one cardinal sign in giant cell arteritis |
| title_full_unstemmed | Choroidal ischemia as one cardinal sign in giant cell arteritis |
| title_short | Choroidal ischemia as one cardinal sign in giant cell arteritis |
| title_sort | choroidal ischemia as one cardinal sign in giant cell arteritis |
| topic | Giant cell arteritis Choroidal hypoperfusion Paracentral acute middle maculopathy Fluorescein angiography OCTA Arteritic anterior ischemic optic neuropathy |
| url | https://doi.org/10.1186/s40942-022-00422-z |
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