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BMC Ophthalmol. 2018 Oct 30;18(1):282. doi: 10.1186/s12886-018-0953-5.

Giant cell arteritis presenting as bilateral anterior ischemic optic neuropathy: a biopsy-proven case report in Chinese patient.

Author information

1
Department of Ophthalmology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, 200031, China. valentian99@hotmail.com.
2
NHC Key Laboratory of Myopia, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. valentian99@hotmail.com.
3
Department of Neurology, Shanghai Deji Hospital, Shanghai, 200010, China.
4
Department of Ophthalmology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, 200031, China.
5
NHC Key Laboratory of Myopia, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
6
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
7
Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.

Abstract

BACKGROUND:

Giant cell arteritis (GCA) is a systemic vasculitis of medium and large-size vessels and can led to permanent visual loss in elderly patients. GCA is very rare among Asians. We report a Chinese patient presenting with acute bilateral anterior ischemic optic neuropathy, and the temporal artery biopsy proved the diagnose of GCA.

CASE PRESENTATION:

A 77-year-old Chinese man presented with sudden bilateral blindness for 5 days with a severe headache. Funduscopic examination revealed bilateral optic disc swollen with "chalky white" pallid appearance. The blood tests showed the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevated dramatically. The color duplex ultrasonography (CDUS) of the superficial temporal artery revealed the inflammation of the vessel wall as a "halo sign". The temporal artery biopsy was perfumed and the pathology revealed luminal occlusion with multinuclear giant cell infiltration. The patient was treated with intravenous methylprednisolone for 3 days and oral prednisone weaning for 12 months. The visual acuity remained no light perception at one year follow-up.

CONCLUSIONS:

Although very rare in Asian, GCA can led to permanent blindness in elderly Chinese caused by anterior ischemic optic neuropathy. The noninvasive CDUS might be a promising technique for diagnose GCA in highly suspected patients.

KEYWORDS:

Anterior ischemic optic neuropathy; Asian; Giant cell arteritis; Temporal biopsy; Ultrasonography

PMID:
30376812
PMCID:
PMC6208180
DOI:
10.1186/s12886-018-0953-5
[Indexed for MEDLINE]
Free PMC Article

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