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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Bilateral Optic Disc Swelling with Preserved Visual Function Associated with Giant Cell Arteritis.

Mihoko Mochiji1, Yukari Yamane1, Akiko Ishida1

  • 1Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan.

Case Reports in Ophthalmology
|August 20, 2021
PubMed
Summary

Giant cell arteritis (GCA) can present as bilateral optic disc swelling (ODS) without vision loss. This case highlights the importance of thorough ocular assessment for diagnosing rare GCA manifestations.

Keywords:
Bilateral optic disc swellingGiant cell arteritisPositron emission tomography

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Area of Science:

  • Ophthalmology
  • Rheumatology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries.
  • Ocular manifestations of GCA typically include visual disturbances, but optic disc swelling (ODS) is less common.

Observation:

  • A 68-year-old man presented with bilateral ODS and floaters, but no visual impairment.
  • Fundus examination revealed peripapillary vessel changes suggestive of arteritis.
  • Diagnostic workup, including imaging and inflammatory markers, confirmed GCA.

Findings:

  • Bilateral ODS was observed in a patient with confirmed GCA.
  • Fluorescein angiography showed optic disc hyperfluorescence without leakage.
  • Enlarged blind spots were noted, but no significant visual field defects or central scotomas were present.

Implications:

  • This case demonstrates that GCA can manifest as bilateral ODS without visual compromise.
  • Ocular findings, even subtle ones like peripapillary vessel changes, are crucial for diagnosing rare GCA presentations.
  • Early diagnosis and treatment with steroids are essential to prevent vision loss in GCA.