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Related Experiment Videos

Choroidal nonperfusion in giant cell arteritis

D A Quillen1, W A Cantore, S R Schwartz

  • 1Department of Ophthalmology, Penn State University College of Medicine, Hershey, Pennsylvania.

American Journal of Ophthalmology
|August 15, 1993
PubMed
Summary

Giant cell arteritis can cause isolated choroidal nonperfusion, leading to reversible vision loss. Prompt corticosteroid treatment restored visual acuity and choroidal circulation in a patient.

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Area of Science:

  • Ophthalmology
  • Rheumatology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium-sized arteries.
  • Ocular manifestations of GCA can lead to irreversible vision loss, including anterior ischemic optic neuropathy and central retinal artery occlusion.
  • Isolated choroidal ischemia is a less common but significant cause of visual impairment in GCA.

Observation:

  • A 68-year-old male presented with visual loss attributed to isolated choroidal nonperfusion.
  • Ophthalmoscopy revealed characteristic yellow-white lesions in the posterior pole of the right eye.
  • Fluorescein angiography showed delayed choroidal filling in the macula, without signs of anterior ischemic optic neuropathy or central retinal artery occlusion.

Findings:

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  • Intravenous corticosteroid therapy initiated within 72 hours resulted in significant visual acuity improvement.
  • Repeat fluorescein angiography confirmed the normalization of choroidal circulation post-treatment.
  • The case highlights the reversibility of visual loss when GCA affects choroidal perfusion.

    • Implications:

    • Early diagnosis and treatment of GCA-induced choroidal ischemia are crucial for vision preservation.
    • Isolated choroidal nonperfusion should be considered in the differential diagnosis of vision loss in GCA patients.
    • This finding underscores the importance of comprehensive ophthalmic evaluation in GCA management.