Ocular manifestations of giant cell arteritis

ABSTRACT

Introduction: Giant Cell Arteritis (GCA) is a vasculitis of the elderly that requires prompt diagnosis and treatment to preserve vision. As life expectancy increases in the United States and worldwide, the incidence of GCA is expected to rise. High dose steroids are often required to control the disease, but have risks, especially when used long term. Therefore, accurate and timely diagnosis, treatment, and monitoring of GCA may increase the likelihood of maintaining vision and quality of life.

Areas covered: This review provides an overview of GCA with an emphasis on ophthalmologic manifestations. It summarizes the impact of new imaging advances in diagnosing GCA and the role imaging plays in relation to temporal artery biopsies. We discuss the latest treatment options and discuss the most recent clinical trials.

Expert commentary: Although GCA is a systemic vasculitis, the symptoms may be highly variable and may be isolated to the eye. Understanding the various clinical presentations of the disease can lead to more rapid recognition and treatment. Although the temporal artery biopsy (TAB) remains the primary pathologic confirmation of the diagnosis of GCA, the diagnostic role of ultrasound and other imaging modalities of the temporal artery continues to improve and may eventually replace the TAB. Corticosteroids remain the mainstay of treatment for GCA, but exciting new treatment options are emerging (e.g. tocilizumab).

KEYWORDS:

• Giant cell arteritis
• ischemic optic neuropathy
• retinal artery occlusion
• visual loss
• temporal artery biopsy

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to discl

Additional information

Funding

This paper was not funded.