From the Jules Stein Eye Institute, University of California, Los Angeles, and West Los Angeles Veterans Affairs Hospital (Dr Gordon), and Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison (Dr Levin).
Edited by Ronna Henry Siegel, MD, Contributing Editor.
VISUAL LOSS is one of the most serious sequelae of giant cell (temporal)
arteritis (GCA), a systemic vasculitis of medium and large arteries. GCA primarily
affects individuals aged 55 years or older; the annual incidence of GCA is
approximately 18 per 100000 persons aged 50 years or older.1
Permanent visual loss occurs in an estimated 15% to 20% of patients with GCA.2 The visual loss associated with GCA usually results
from ischemic infarction of the optic nerve or retina3,4
secondary to the vasculitic involvement of the posterior ciliary or central
retinal arteries, respectively.4 Patients with
GCA may complain of a stuttering quality to their vision, an area of visual
distortion, or the sudden and permanent loss of all or a portion of the vision
in 1 or both eyes. In a retrospective study, premonitory visual symptoms occurred
in approximately 65% of patients with subsequent permanent visual loss and
included diplopia, amaurosis fugax, and visual blurring.2
The onset of visual abnormalities antedated the onset of visual loss by an
average of 8.5 days.
Gordon LK, Levin LA. Visual Loss in Giant Cell Arteritis. JAMA. 1998;280(4):385-386. doi:10.1001/jama.280.4.385