The Spectrum of Isolated Retinal Artery Occlusion Secondary to Giant Cell Arteritis

Area of Science:

• Ophthalmology
• Rheumatology
• Vascular Medicine

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis that can affect large and medium-sized arteries.
• Retinal artery occlusion (RAO) is a serious complication that can lead to vision loss.
• Distinguishing arteritic RAO (A-RAO) from non-arteritic RAO is crucial for appropriate management.

Purpose of the Study:

• To systematically review the literature on the clinical features of isolated arteritic retinal artery occlusion (A-RAO) in patients with giant cell arteritis (GCA).
• To identify the different types and presentations of A-RAO associated with GCA.
• To highlight clinical features that differentiate A-RAO from non-arteritic RAO.

Main Methods:

• Systematic literature review.
• Analysis of clinical features, types of A-RAO, and associated GCA symptoms.
• Review of diagnostic confirmation, including temporal artery biopsy.

Main Results:

• The four primary types of A-RAO identified were central retinal artery occlusion (CRAO), hemi-central retinal artery occlusion (hCRAO), branch retinal artery occlusion (BRAO), and cilioretinal artery occlusion (CLRAO).
• Unilateral CRAO was the most frequently reported presentation, followed by bilateral CRAO, unilateral CLRAO, and bilateral BRAO.
• Most A-RAOs were associated with typical GCA signs and symptoms, and temporal artery biopsy confirmed GCA in most cases.

Conclusions:

• Giant cell arteritis (GCA) can manifest with a diverse range of isolated unilateral and bilateral arteritic retinal artery occlusions (A-RAOs).
• The presence of characteristic GCA symptoms aids in distinguishing A-RAO from non-arteritic RAO.
• Prompt recognition and diagnosis of GCA are essential for managing A-RAO and preventing further vascular events.