DOI: https://doi.org/10.22141/2309-8147.5.1.2017.172582

CASE OF BILATERAL ACUTE OPTICAL ISCHEMIC NEUROPATHY IN GIANT CELL ARTERITIS

N. S. Lutsenko, O. A. Rudycheva, O. A. Isakova, N. F. Polyakov

Abstract


Giant cell arteritis (GCA) is a chronic infl ammatory vasculitis involving the medium and large-sized vessels. Ischemic optic neuropathy is a major cause of blindness or signifi cantly impaired vision. One of the rare reason of acute optical neuropathy is arteritic infl ammation in GCA. We present a case of bilateral acute optical ischemic neuropathy in 74 year old female that led to the bilateral blindness. Her past medical history didn’t reveal any features. The main complain was visual loss. Laboratory fi ndings include elevated ESR and C reactive protein. Duplex sonography didn’t reveal clinically signifi cant changes in extra and intracranial vessels except blood value reduction in ophthalmic artery on the left eye and complete absence of blood fl ow on the right eye. Temporal artery biopsy was performed. The histopathological changes in the temporal arteries revealed luminal stenosis, intimal proliferation and disruption of internal elastic lamina, infi ltration by lymphocytes, macrophages, and multinucleated giant cells. Treatment with high dosage of methyl prednisolone was started before the results of biopsy. The diagnosis, differential diagnosis and treatment are discussed.


Keywords


giant cell arteritis, temporal artery biopsy

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