Article ; Online: Frequency of visual involvement in a 10-year interdisciplinary cohort of patients with giant cell arteritis.
Clinical medicine (London, England)
2023 Volume 23, Issue 3, Page(s) 206–212
Abstract: Background: We present the largest study of the frequency and nature of visual complications in a cohort of 350 patients consecutively diagnosed with giant cell arteritis (GCA).: Methods: All individuals were assessed using structured forms and ... ...
| Abstract | Background: We present the largest study of the frequency and nature of visual complications in a cohort of 350 patients consecutively diagnosed with giant cell arteritis (GCA). Methods: All individuals were assessed using structured forms and diagnosed using imaging or biopsy. A binary logistic regression model was used to analyse data for predicting visual loss. Results: Visual symptoms occurred in 101 (28.9%) patients, with visual loss in one or both eyes in 48 (13.7%) patients. Four patients had binocular visual loss. Anterior ischaemic optic neuropathy (N=31), retinal artery obstruction (N=8) and occipital stroke (N=2) were the main causes of visual loss. Of the 47 individuals who had repeat visual acuity testing at 7 days, three individuals had improvement to 6/9 or better. After introducing the fast-track pathway, the frequency of visual loss decreased from 18.7% to 11.5%. Age at diagnosis (odds ratio (OR) 1.12) and headache (OR 0.22) were significant determinants of visual loss in a multivariate model. Jaw claudication trended to significance (OR 1.96, p=0.054). Conclusions: We recorded a visual loss frequency of 13.7% in the largest cohort of patients with GCA examined from a single centre. Although improvement in vision was rare, a dedicated fast-track pathway reduced visual loss. Headache could result in earlier diagnosis and protect against visual loss. |
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| MeSH term(s) | Humans ; Giant Cell Arteritis/complications ; Giant Cell Arteritis/epidemiology ; Giant Cell Arteritis/diagnosis ; Optic Neuropathy, Ischemic/etiology ; Optic Neuropathy, Ischemic/complications ; Vision Disorders/etiology ; Vision Disorders/complications ; Retinal Artery Occlusion/complications ; Headache/etiology | |||||
| Language | English | |||||
| Publishing date | 2023-05-17 | |||||
| Publishing country | England | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2048646-7 | |||||
| ISSN | 1473-4893 ; 1470-2118 | |||||
| ISSN (online) | 1473-4893 | |||||
| ISSN | 1470-2118 | |||||
| DOI | 10.7861/clinmed.2022-0415 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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