A 71-year-old woman experienced vision loss for 2 weeks in her right eye along with jaw pain, headache, fevers, and malaise. Her visual acuity was 20/200 OD and 20/30 OS. She had a right afferent pupillary defect. Findings from her fundus examination were normal except for rare cotton-wool spots (Figure 1). Her blood pressure was normal. A fluorescein angiogram revealed delayed choroidal filling in both eyes (Figure 2 and Figure 3). She was immediately started on therapy with high-dose oral prednisone. Results from temporal artery biopsy were positive. One month later, her visual acuity had improved to 20/40 OD and 20/30 OS.
Cohen S, Gardner F. Bilateral Choroidal Ischemia in Giant Cell Arteritis. Arch Ophthalmol. 2006;124(6):922. doi:10.1001/archopht.124.6.922