Orbital MRI Findings in a Patient With Giant Cell Arteritis (GCA): A Case Report

Giant cell arteritis (GCA) is a medium- and large-vessel systemic vasculitis. It is common among people aged 50 years and older. GCA presents with cranial manifestations of headache, visual symptoms, cerebrovascular events, and systemic manifestations. The diagnosis of GCA is confirmed with a positive temporal artery biopsy. Treatment of GCA consists of high-dose steroids with slow tapering over 18 to 24 months and steroid-sparing therapy to maintain remission. Due to the risk of the most feared complication of GCA, irreversible visual loss, once GCA is suspected, high-dose steroids should be commenced immediately, and a temporal artery biopsy should be done not beyond one to two weeks after starting steroids to avoid the effects of steroids on the result of the temporal artery biopsy. There are orbital radiological findings reported in patients with an atypical presentation of GCA on MRI; these findings include non-specific orbital inflammation, optic nerve inflammation, optic nerve sheath inflammation, and optic chiasm enhancement.