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Bilateral arteritic central retinal artery occlusion in a Chinese patient
1Prince of Wales Hospital Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, New Territories.
Insights
This case report details the first instance of bilateral central retinal artery occlusion in a Chinese patient due to giant cell arteritis. Early steroid treatment successfully prevented further vision loss, highlighting the importance of prompt diagnosis.
Area of Science:
- Ophthalmology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
- Ophthalmologic manifestations, such as central retinal artery occlusion (CRAO), can lead to irreversible vision loss.
- GCA is less common in Asian populations, making its presentation in this demographic noteworthy.
Observation:
- A Chinese patient presented with symptoms including weight loss, calf claudication, and sequential bilateral CRAO.
- Elevated erythrocyte sedimentation rate (>150 mm/h) was observed.
- Temporal artery biopsy confirmed the diagnosis of GCA.
Findings:
- The patient experienced sequential CRAO in both eyes.
- Systemic corticosteroid therapy was initiated.
- Treatment with systemic steroids halted further visual deterioration in the second affected eye.
Implications:
- This report represents the first documented case of GCA-induced bilateral CRAO in a Chinese individual.
- GCA should be considered in the differential diagnosis of CRAO, particularly in patients with suggestive systemic symptoms.
- Timely diagnosis and initiation of immunosuppressive therapy are crucial for preserving vision and preventing blindness in GCA patients presenting with CRAO.
Purpose:
To report the first case of bilateral central retinal artery occlusion caused by giant cell arteritis in a Chinese patient.
Methods:
We studied a Chinese patient who had a history of weight loss, calf claudication and sequential right and left central retinal artery occlusion.
Results:
The erythrocyte sedimentation rate was greater than 150 mm/h. Temporal artery biopsy confirmed the diagnosis of giant cell arteritis. Systemic steroid prevented further visual loss in the second eye.
Conclusions:
We believe that this is the first report in literature on the ophthalmological presentation of giant cell arteritis in a Chinese patient. Giant cell arteritis as a cause of central retinal artery occlusion should always be on the list of differential diagnosis, as early diagnosis and treatment may help to salvage the first eye and prevent blindness from developing in the second eye.