Recurrent Vision Loss in a Patient with Giant Cell Arteritis while on High Dose Corticosteroids.

Area of Science:

• Rheumatology
• Ophthalmology

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium arteries.
• It is a leading cause of non-traumatic blindness in the elderly.

Observation:

• A patient with established GCA and prior vision loss presented with recurrent acute visual decline.
• Initial treatment with intravenous steroids led to temporary improvement, followed by a second episode of vision loss.

Findings:

• No alternative diagnosis was identified despite a comprehensive workup.
• Temporal artery biopsy was deferred due to concerns of false-negative results in patients on chronic glucocorticoids.

Implications:

• This case underscores the potential for recurrent vision loss in GCA even during acute treatment.
• It highlights the complexities of diagnosing and managing GCA in patients with long-term glucocorticoid exposure.
• Further research into monitoring and diagnostic strategies for GCA in this context is warranted.