Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis

Ling Bei,1 Iris Lee,2 Michael S Lee,3 Greg P Van Stavern,1 Collin M McClelland3 1Department of Ophthalmology and Visual Neurosciences, Washington University School of Medicine, St Louis, MO, 2Casey Eye Institute, Oregon Health and Science University, Portland, OR, 3Department of Ophthalmology and Vi...

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Main Authors: Bei L, Lee I, Lee MS, Van Stavern GP, McClell, CM
Format: Article
Language:English
Published: Dove Medical Press 2016-09-01
Series:Clinical Ophthalmology
Subjects:
Online Access:https://www.dovepress.com/acute-vision-loss-and-choroidal-filling-delay-in-the-absence-of-giant--peer-reviewed-article-OPTH
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author Bei L
Lee I
Lee MS
Van Stavern GP
McClell
CM
author_facet Bei L
Lee I
Lee MS
Van Stavern GP
McClell
CM
author_sort Bei L
collection DOAJ
description Ling Bei,1 Iris Lee,2 Michael S Lee,3 Greg P Van Stavern,1 Collin M McClelland3 1Department of Ophthalmology and Visual Neurosciences, Washington University School of Medicine, St Louis, MO, 2Casey Eye Institute, Oregon Health and Science University, Portland, OR, 3Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA Abstract: Giant-cell arteritis (GCA) is a visually devastating disease that often progresses to severe bilateral vision loss if untreated. Diagnosis of GCA is made challenging by the protean nature of the disease and the lack of a simple test that is both highly sensitive and specific. Choroidal filling delay on fluorescein angiography (FA) has been touted as a highly characteristic feature of GCA-related vision loss, although knowledge of both the sensitivity and specificity of this finding remains unproven. We report our experience of delayed choroidal filling on FA in a series of seven patients referred to an academic neuro-ophthalmology practice due to concern for GCA. Despite the FA findings, our examination, diagnostic testing, and long-term follow-up excluded the diagnosis of GCA in all cases, suggesting that choroidal perfusion abnormalities may occur in the absence of GCA. When evaluating a patient for acute vision loss, the astute clinician must remain cognizant of the limitations of FA in the diagnosis of GCA.Keywords: giant-cell arteritis, fluorescein angiography, delayed choroidal filling
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spelling doaj.art-dd21111778fa4afa885f50ccddacf8c52022-12-21T20:09:13ZengDove Medical PressClinical Ophthalmology1177-54832016-09-01Volume 101573157828901Acute vision loss and choroidal filling delay in the absence of giant-cell arteritisBei LLee ILee MSVan Stavern GPMcClellCMLing Bei,1 Iris Lee,2 Michael S Lee,3 Greg P Van Stavern,1 Collin M McClelland3 1Department of Ophthalmology and Visual Neurosciences, Washington University School of Medicine, St Louis, MO, 2Casey Eye Institute, Oregon Health and Science University, Portland, OR, 3Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA Abstract: Giant-cell arteritis (GCA) is a visually devastating disease that often progresses to severe bilateral vision loss if untreated. Diagnosis of GCA is made challenging by the protean nature of the disease and the lack of a simple test that is both highly sensitive and specific. Choroidal filling delay on fluorescein angiography (FA) has been touted as a highly characteristic feature of GCA-related vision loss, although knowledge of both the sensitivity and specificity of this finding remains unproven. We report our experience of delayed choroidal filling on FA in a series of seven patients referred to an academic neuro-ophthalmology practice due to concern for GCA. Despite the FA findings, our examination, diagnostic testing, and long-term follow-up excluded the diagnosis of GCA in all cases, suggesting that choroidal perfusion abnormalities may occur in the absence of GCA. When evaluating a patient for acute vision loss, the astute clinician must remain cognizant of the limitations of FA in the diagnosis of GCA.Keywords: giant-cell arteritis, fluorescein angiography, delayed choroidal fillinghttps://www.dovepress.com/acute-vision-loss-and-choroidal-filling-delay-in-the-absence-of-giant--peer-reviewed-article-OPTHgiant cell arteritisfluorescein angiographydelayed choroidal filling
spellingShingle Bei L
Lee I
Lee MS
Van Stavern GP
McClell
CM
Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
Clinical Ophthalmology
giant cell arteritis
fluorescein angiography
delayed choroidal filling
title Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
title_full Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
title_fullStr Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
title_full_unstemmed Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
title_short Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
title_sort acute vision loss and choroidal filling delay in the absence of giant cell arteritis
topic giant cell arteritis
fluorescein angiography
delayed choroidal filling
url https://www.dovepress.com/acute-vision-loss-and-choroidal-filling-delay-in-the-absence-of-giant--peer-reviewed-article-OPTH
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