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Recovery of visual function in patients with biopsy-proven giant cell arteritis
Rod Foroozan1, Vincent A Deramo, Lawrence M Buono
1Neuro-Ophthalmology Service, Jefferson Medical College, Thomas Jefferson University, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA 19107, USA.
Objective:
To assess the visual function of patients with giant cell arteritis (GCA) who had visual loss from either anterior ischemic optic neuropathy (AION) or central retinal artery occlusion and had a subsequent improvement in visual acuity after treatment with corticosteroids.
Design:
Retrospective, observational case series.
Participants:
Thirty-two consecutive patients with biopsy-proven GCA treated at one institution between January 1992 and December 1997.
Intervention:
Treatment with intravenous methylprednisolone 250 mg every 6 hours for 3 days, followed by oral prednisone 1 mg/kg daily for at least 4 weeks duration.
Main Outcome Measures:
The number of patients with an improvement in visual acuity after treatment with intravenous methylprednisolone; neuro-ophthalmic evaluation, including visual acuity, funduscopy, and visual field examination of these patients.
Results:
Improvement in visual acuity occurred in 5 of 39 eyes (13%) with visual loss from biopsy-proven GCA, and all 5 patients had AION. Despite the improvement of visual acuity in these 5 patients, perimetry revealed marked constriction of the visual field in each affected eye.
Conclusions:
The prognosis for visual improvement in GCA is poor. Although an improvement in visual acuity occurred in 5 of our patients, marked constriction of the visual field was present in all of them.