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Peripheral retinal arteriolar leakage in giant cell arteritis: a case report
Meleha Ahmad1, Andrew R Carey1, Charles G Eberhart1
1Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA.
Journal of Ophthalmic Inflammation and Infection
|January 29, 2021
Summary
Giant cell arteritis (GCA) can affect small retinal vessels, causing vision loss. This case highlights peripheral small vessel arteriolar leakage in GCA, a rare but significant finding.
Area of Science:
- Ophthalmology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) typically involves medium to large arteries.
- Arteritic ischemic optic neuropathy (AION) is a known complication of GCA.
- Small vessel involvement in GCA is considered rare.
Purpose of the Study:
- To report a unique case of peripheral small vessel retinal arteriolar leakage in GCA.
- To investigate the association between GCA and small vessel retinal pathology.
Main Methods:
- Case presentation of a 76-year-old female with GCA and AION.
- Clinical examination including dilated fundus examination.
- Fluorescein angiography to assess retinal vasculature.
- Temporal artery biopsy review.
- Laboratory tests for alternative vasculitides.
Main Results:
- The patient presented with unilateral vision loss despite steroid treatment.
- Fundus examination showed cotton wool spots.
- Fluorescein angiography revealed slowed arteriolar filling and peripheral arteriolar staining.
- Temporal artery biopsy confirmed GCA with lymphoplasmacytic inflammation.
- Findings were consistent with small vessel arteritis affecting the retina.
Conclusions:
- This case demonstrates peripheral small vessel retinal arteriolar leakage as a rare manifestation of GCA.
- The findings suggest that GCA may involve small retinal vessels, contrary to common understanding.
- This association warrants further investigation into the spectrum of GCA vascular pathology.
