Título

CHOROIDAL ISCHEMIA AS ONE CARDINAL SIGN IN GIANT CELL ARTERITIS

Objetivo

Purpose: To describe chorioretinal signs of Giant Cell Arteritis (GCA).

Método

Methods: This is a multicenter retrospective observational case series of GCA presenting with sudden unilateral drop in vision accompanied by headache. Workup included intravenous fluorescein angiography, OCT, OCTA, ESR and CRP blood levels, as well as temporal artery biopsy.

Resultado

Results: A total of 8 cases with GCA are presented. Mean age was 74.5 (range 68-83 years). The patients complained of sudden onset of vision loss in one eye accompanied by new headache, and some other systemic manifestations. At presentation, 8 patients had choroidal ischemia, 5 paracentral acute middle maculopathy (PAMM) lesions, 5 cotton wool spots, 4 arteritic anterior ischemic optic neuropathy, and one central retinal arterial occlusion. Mean ESR at presentation was 68 mm/hr (range 4-110) with marked elevation in 4/6 patients. Mean CRP was 6.2 mg/dL (range 2.0-15.4)) and the level was above normal limits in all cases. Temporal artery biopsy was positive in all patients.

Conclusão

Conclusion: Choroidal ischemia constitutes a cardinal angiographic sign in the diagnosis of GCA, besides PAMM lesions, cotton wool spots, arteritic anterior ischemic optic neuropathy and central retinal artery occlusion. Awareness of typical ischemic chorioretinal findings may be of great importance in the diagnosis of GCA.