Bilateral central retinal artery occlusion in occult temporal arteritis

Area of Science:

• Ophthalmology
• Rheumatology
• Vascular Medicine

Background:

• Central retinal artery occlusion (CRAO) is a critical condition leading to sudden vision loss.
• Temporal arteritis, a form of vasculitis, can affect large and medium-sized arteries, including those supplying the eye.
• Occult or subclinical temporal arteritis presents a diagnostic challenge, potentially leading to delayed treatment.

Observation:

• This report details a rare instance of bilateral central retinal artery occlusion.
• The occlusion was found to be caused by previously undiagnosed (occult) temporal arteritis.
• The patient presented with severe visual impairment in both eyes.

Findings:

• Histopathological examination confirmed giant cell arteritis in the temporal artery biopsy.
• The findings underscore the potential for temporal arteritis to manifest as bilateral CRAO.
• Early diagnosis and treatment of temporal arteritis are vital to prevent irreversible vision loss.

Implications:

• The study highlights the importance of considering temporal arteritis in all elderly patients presenting with CRAO, even in the absence of typical symptoms.
• A high index of suspicion and prompt temporal artery biopsy are recommended for diagnosing occult temporal arteritis.
• Timely intervention can prevent further vascular events and preserve vision in affected individuals.