Population-based Rate and Patterns of Diplopia in Giant Cell Arteritis

ABSTRACT

Giant cell arteritis (GCA) is the most common vasculitis in older adults with permanent vision loss as a feared complication. Diplopia has been reported in a small percentage of patients with visual manifestations. The goal of this study was to determine the population-based rates and patterns of binocular diplopia from GCA. The Rochester Epidemiology Project (REP), a medical records linkage system was used to identify all residents of Olmsted County, Minnesota, USA, diagnosed with GCA between January 1, 1950 and December 31, 2019. Medical records were then reviewed to identify patients with binocular diplopia from GCA. There were 301 incident cases of GCA from 1950 to 2019. Fourteen (5%) patients presented with binocular diplopia. Of these 14 patients, nine (3%) had constant diplopia and five (2%) had transient diplopia. Among patients with constant diplopia, cranial nerve VI involvement was suspected in four (44%) cases. Systemic symptoms and inflammatory markers were similar in patients with and without diplopia. There was no difference in the rate of anterior ischaemic optic neuropathy between the two groups (7% vs. 7%, p = 1.00). In conclusion, this population-based study showed that binocular diplopia was present in 5% of patients with GCA, which could either be transient or constant. GCA patients with diplopia had similar systemic manifestations and risk of vision loss as GCA patients without diplopia.

KEYWORDS:

• Diplopia
• giant cell arteritis
• population-based

Declaration of interest statement

The authors report no conflict of interest.

Additional information

Funding

This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676, and Grant Number UL1TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.