Contempo 1998
July 22/29, 1998

Visual Loss in Giant Cell Arteritis

Author Affiliations

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.

JAMA. 1998;280(4):385-386. doi:10.1001/jama.280.4.385

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.

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