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Updated: Jun 6, 2026

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

Occult temporal arteritis in a 54-year-old man.

Flora Levin¹, Hermann D Schubert, John C Merriam

¹Department of Ophthalmology, Yale University, New Haven, Connecticut 06510, USA. floralevin@gmail.com

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society

|December 8, 2010

Summary

This summary is machine-generated.

Temporal arteritis (TA) can cause transient monocular visual loss (TMVL) and retinal changes, even with normal inflammatory markers. Early diagnosis and steroid treatment are crucial for preventing vision loss and systemic complications.

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Area of Science:

Ophthalmology
Rheumatology
Vascular Medicine

Background:

Temporal arteritis (TA), a large-vessel vasculitis, typically affects individuals over 50.
Ocular manifestations of TA can include transient monocular visual loss (TMVL) and permanent vision impairment.
Prompt diagnosis and treatment are vital to prevent irreversible vision loss and systemic complications.

Observation:

A 54-year-old man with a history of pars planitis presented with recurrent episodes of TMVL in the left eye.
Initial examination revealed retinal vascular sheathing and delayed arterial filling; inflammatory markers and imaging were normal.
Subsequent development of cotton wool spots, afferent pupillary defect, and visual field loss in the left eye prompted further investigation.

Findings:

Temporal artery biopsy confirmed granulomatous inflammation, consistent with temporal arteritis (TA).
Chest imaging showed dilation of the ascending aorta, indicating potential systemic involvement.
High-dose oral steroids led to resolution of TMVL, retinal findings, and reduced temporal artery size.

Implications:

This case highlights the importance of considering TA in patients with TMVL, visual disturbances, and retinal findings, even with normal inflammatory markers.
Nontender, dilated temporal arteries can be a sign of TA, necessitating thorough evaluation.
Long-term follow-up is essential due to the significant risk of ocular and systemic morbidity associated with TA.