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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Giant Cell Arteritis Presenting as Bilateral Cotton Wool Spots.

Lanxing Fu1, Eoin P O'Sullivan1

  • 1Ophthalmology, King's College Hospital, London, GBR.

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|November 7, 2022
PubMed
Summary

Giant cell arteritis (GCA) can cause vision loss, even without typical symptoms. Early detection via symptoms like jaw claudication and fundus findings like cotton wool spots is crucial for prompt treatment and vision recovery.

Keywords:
cotton wool spotsgiant cell arteritisgranulomatous inflammatory vasculitisheadachejaw claudicationpolymyagia rheumaticascalp tenderness

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Area of Science:

  • Ophthalmology
  • Rheumatology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
  • Ocular involvement in GCA can lead to irreversible vision loss if not treated promptly.

Observation:

  • An 81-year-old woman presented with headache, jaw claudication, and decreased vision.
  • Fundus examination revealed peripapillary cotton wool spots, and laboratory tests showed elevated ESR and CRP.
  • Temporal artery ultrasound demonstrated a halo sign, confirming GCA.

Findings:

  • High-dose intravenous methylprednisolone treatment led to rapid visual improvement.
  • Vision stabilized at 6/60 in the right eye and 6/6 in the left eye at 12 months.
  • Cotton wool spots, often associated with GCA, can indicate the need for urgent evaluation.

Implications:

  • This case highlights the importance of recognizing GCA even with atypical presentations.
  • Prompt diagnosis and treatment of GCA are critical for preserving vision.
  • Ophthalmic manifestations, such as cotton wool spots, warrant immediate investigation for GCA.