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Published on: February 8, 2019
Apical Orbital Aspergillosis Complicating Giant Cell Arteritis
Yang Zhou1, Michael L Morgan, Sumayya J Almarzouqi
1Baylor College of Medicine (YZ, AGL, PCB), Adjunct Professor of Ophthalmology, Houston, Texas; Department of Ophthalmology (MLM, SJA, PCB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Genomic Medicine, Houston Methodist (PCB), Houston, Texas; Weill Cornell Medical College, Adjunct Professor of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, Texas; and Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medical College, Houston, Texas; Clinical Professor, UTMB Galveston, TX and the UT MD Anderson Cancer Center, Houston, Texas; Adjunct Professor of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa City.
Abstract:
A 75-year-old woman with new onset headaches and left vision loss, temporal scalp tenderness, and jaw claudication was found to have biopsy-proven giant cell arteritis (GCA). Despite treatment and improvement with prednisone, she later developed left orbital apex syndrome, and an orbital biopsy revealed aspergillosis. After antifungal treatment, extraocular motility improved although vision in the left eye remained no light perception. Clinicians should be aware that fungal orbital apex disease may mimic or complicate steroid-treated GCA.
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