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Published on: February 8, 2019
Large-Vessel Vasculitis in Ophthalmology: Giant Cell Arteritis and Takayasu Arteritis
Ujalashah Dhanani1, Michael Y Zhao2, Chaow Charoenkijkajorn3
1Section of Ophthalmology, Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, US.
Insights
Giant cell arteritis and Takayasu arteritis are distinct large-vessel vasculitides. This review aids ophthalmologists in differentiating these conditions based on epidemiology, clinical signs, and imaging.
Area of Science:
- Ophthalmology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) and Takayasu arteritis (TA) are large-vessel vasculitides with overlapping features.
- Traditional differentiation based on age is insufficient due to evolving diagnostic criteria.
Purpose of the Study:
- To review and compare diagnostic criteria, epidemiology, pathogenesis, and clinical presentations of GCA and TA.
- To highlight ocular manifestations and imaging techniques relevant to ophthalmologists.
- To provide guidance on differentiating these vasculitides.
Main Methods:
- Review of existing literature on GCA and TA.
- Comparison of epidemiological data, clinical features, and diagnostic criteria.
- Discussion of histopathological findings and ocular imaging modalities.
Main Results:
- GCA predominantly affects elderly Caucasians, while TA is more common in younger Asians.
- Significant overlap exists in clinical presentation, necessitating comprehensive evaluation.
- Ocular imaging can reveal characteristic signs of large-vessel vasculitis.
Conclusions:
- Ophthalmologists play a crucial role in the early diagnosis of large-vessel vasculitis.
- Understanding the distinct and overlapping features of GCA and TA is vital for accurate diagnosis and management.
- Integrated clinical, laboratory, and imaging data improve differentiation between GCA and TA.
Abstract:
Giant cell arteritis and Takayasu arteritis are large-vessel vasculitides that share multiple common features but also have significant differences in epidemiology, demographics, clinical presentation, evaluation, and treatment. Giant cell arteritis is more common in elderly patients of Caucasian descent versus Takayasu arteritis, which is more prevalent in younger patients of Asian descent. Although traditionally age has been the main criterion for differentiating the 2 etiologies, modifications in the diagnostic criteria have recognized the overlap between the 2 conditions. In this monograph, we review the diagnostic criteria for both conditions and describe the epidemiology, pathogenesis, histology, evaluation, and management for large-vessel vasculitis in ophthalmology. Additionally, we describe ocular imaging techniques that may be utilized by ophthalmologists to identify manifestations of large-vessel vasculiti- des in patients. Lastly, we compare and contrast the key clinical, laboratory, and pathologic features that might help ophthalmologists to differentiate the 2 entities.
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