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March 1983

Bilateral Blindness in Temporal Arteritis With Skip Areas

Author Affiliations

From the Departments of Ophthalmology (Drs Brownstein, Nicolle, and Codère) and Pathology (Drs Brownstein and Codère), McGill University and Royal Victoria Hospital, Montreal.

Arch Ophthalmol. 1983;101(3):388-391. doi:10.1001/archopht.1983.01040010388007

• A 73-year-old woman received systemic corticosteroids for suspected temporal arteritis after blindness developed in the right eye during the previous day. Because a right temporal artery biopsy specimen was reported as normal, a diagnosis of arteriosclerotic ischemic optic neuropathy was made and the corticosteroid therapy was discontinued. Two weeks later the patient rapidly lost vision in her left eye. A left temporal artery biopsy specimen showed granulomatous arteritis adjacent to normal artery (skip area). Deeper sections of the original right temporal artery biopsy specimen also demonstrated a small focus of granulomatous arteritis adjacent to normal artery. In patients with suspected temporal arteritis, numerous step sections of a long segment of temporal artery should be examined; if the results are normal, the contralateral temporal artery should be studied. A nonspecific inflammatory reaction within or adjacent to the artery should alert the pathologist to the possible presence of a nearby focus of granulomatous arteritis.

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