Vision loss in patients with giant cell arteritis (GCA) typically occurs over the course of seconds to days and often involves the other eye soon after. We describe a patient with arteritic anterior ischemic optic neuropathy and unusually slow progression of reversible vision loss for 1 month in the fellow eye.
A 93-year-old man taking warfarin sodium (Coumadin) because of atrial fibrillation awoke with sudden painless vision loss in the right eye. Visual acuity was counting fingers OD and 20/30 OS. He identified 10 of 10 Ishihara color plates with the left eye. Funduscopy of the right eye revealed hyperemic optic nerve edema with hemorrhages and a small cup-disc ratio in the left eye. Strong bilateral, nontender temporal artery pulses were present. The patient denied systemic symptoms of GCA. The erythrocyte sedimentation rate (Westergren method) was 35 mm/h.
Galor A, Lee MS. Slowly Progressive Vision Loss in Giant Cell Arteritis. Arch Ophthalmol. 2006;124(3):416-418. doi:10.1001/archopht.124.3.416