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Related Experiment Video

Updated: Sep 7, 2025

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

Vision loss in giant cell arteritis: case-based review.

Ioanna Nefeli Kokloni¹, Souzana Ioanna Aligianni¹, Olga Makri²

¹Medical Graduates, University of Patras Medical School, Patras, Greece.

Rheumatology International

|June 21, 2022

Summary

Prompt glucocorticoid treatment for giant cell arteritis (GCA) is crucial. Even with treatment, sequential blindness in the fellow eye can rarely occur, emphasizing the need for immediate intervention to preserve vision.

Keywords:

Blindness Giant cell arteritis Intravenous steroids Pulse glucocorticoids Pulse steroids Temporal arteritis Vision loss

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Area of Science:

Ophthalmology
Rheumatology
Neurology

Background:

Giant cell arteritis (GCA) is a vasculitis that can cause vision loss.
Prompt glucocorticoid treatment is recommended for suspected or proven GCA with visual symptoms.
Pulse therapy aims to prevent involvement of the unaffected fellow eye.

Observation:

A case of biopsy-proven GCA in a 79-year-old man resulted in sequential bilateral blindness.
Despite initial intravenous methylprednisolone and oral prednisone, the second eye lost vision 11 days after initial unilateral vision loss.
A systematic literature search identified 21 additional patients with GCA experiencing contralateral vision loss under pulse treatment for monocular vision loss.

Findings:

Contralateral vision loss occurred 1-12 days after treatment initiation (median 2 days).
Treatment initiation was delayed up to 8 days from initial vision loss (median 2 days).
Anterior ischemic optic neuropathy was the primary cause of vision loss.

Implications:

Sequential involvement of the fellow eye in GCA-related vision loss is rare but can occur.
While the first 2 days are critical, vision loss can happen later.
Immediate initiation of pulse glucocorticoid treatment is vital for preserving vision in the contralateral eye.