scholarly journals Refractory Giant Cell Arteritis Complicated by Vision Loss From Optic Atrophy and Maculopathy Associated With Pachymeningitis

2018 ◽  
Vol 38 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Jorge A. Uribe ◽  
Ishita Aggarwal ◽  
Juthamat Witthayaweerasak ◽  
Y. Joyce Liao ◽  
Gerald J. Berry ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Atrophy ◽  
Vision Loss

scholarly journals Vision Loss in Patients with Giant Cell Arteritis Treated with Tocilizumab

2020 ◽  
Author(s):  
Jennifer Amsler ◽  
Iveta Kysela ◽  
Christoph Tappeiner ◽  
Luca Seitz ◽  
Lisa Christ ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Structural Changes ◽  
Vision Loss ◽  
Treated Patient ◽  
Laboratory Data ◽  
Reactive Protein ◽  
American College Of Rheumatology ◽  
Low Incidence ◽  
Initiation Of Therapy

Abstract Objectives: Giant cell arteritis (GCA) may lead to vision loss. To what extent tocilizumab (TCZ) is able to prevent vision loss is unknown. The aim was to analyze the occurrence of vision loss in a large GCA cohort treated with TCZ.Methods: In this observational monocentric study, GCA patients treated with TCZ between the years 2010 and 2018 were studied. Demographic, clinical and laboratory data were analyzed. Results: A total of 186 patients were included (62% female); 109 (59%) fulfilled the American College of Rheumatology (ACR) criteria, in 123 (66%) patients, large vessel vasculitis was diagnosed in magnetic resonance-angiography (MRA). Cumulative duration of TCZ treatment was 224 years, median treatment duration was 11.1 (IQR 5.6-17.9) months. Glucocorticoids (GC) were tapered over a median of 5.8 (IQR 3.0-8.5) months. At baseline, visual symptoms were present in 70 (38%) and vision loss in 21 (11%) patients. Patients with vision loss at baseline were older (p=0.032), had a lower C-reactive protein (p=0.002), more often cranial symptoms (p<0.001) or jaw claudication (p=0.031) and showed a negative association with MRA of the aorta (p=0.006). Two patients (1.1%) developed vision loss, both at initiation of TCZ treatment.Conclusion: Our data show a very low incidence of vision loss in TCZ-treated patient. The two cases of AION occurred at initiation of therapy, they support the hypothesis that advanced, and established structural changes of arteries are key factors for this accident. Whether shorter duration of concomitant GC treatment is risky regarding vision loss needs to be studied.

Vision Loss From Giant Cell Arteritis in Patients With Other Ocular Diagnoses

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Prem Nichani ◽  
Valérie Biousse ◽  
Nancy J. Newman ◽  
Jonathan A. Micieli
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss

scholarly journals Evaluating the Incidence of Arteritic Ischemic Optic Neuropathy and Other Causes of Vision Loss from Giant Cell Arteritis

Ophthalmology ◽  
2016 ◽  
Vol 123 (9) ◽  
pp. 1999-2003 ◽  
Author(s):  
John J. Chen ◽  
Jacqueline A. Leavitt ◽  
Chengbo Fang ◽  
Cynthia S. Crowson ◽  
Eric L. Matteson ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Ischemic Optic Neuropathy

scholarly journals Giant Cell Arteritis Presenting as Choroidal Infarction

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nikolaos Kopsachilis ◽  
Maria Pefkianaki ◽  
Anca Marinescu ◽  
Sobha Sivaprasad
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Retinal Vessel ◽  
Interesting Case ◽  
Vessel Occlusion ◽  
Systemic Complications ◽  
Ocular Manifestations ◽  
Granulomatous Vasculitis ◽  
Choroidal Infarction

Background. Giant cell arteritis (GCA) is a systemic granulomatous vasculitis that affects large- and medium-sized arteries of the head and neck. Ocular manifestations of GCA usually are anterior ischaemic optic neuropathy (AION) or retinal vessel occlusion.Case Report. We report an interesting case of a 70-year-old man who presented with sudden vision loss and choroidal infarction in his left eye. Thorough clinical and paraclinical evaluation revealed an underlying GCA, the treatment of which prevented further vision loss and systemic complications.Conclusion. This is an unusual presentation of choroidal infarction associated with CGA and emphasizes the need of thorough systemic evaluation in patients with choroidal infarction.

scholarly journals A typical case of giant cell arteritis with vision loss due to delayed diagnosis

2018 ◽  
Vol 19 (4) ◽  
pp. 139-140
Author(s):  
Ami Watanabe ◽  
Hiroki Isono ◽  
Kaoru Shimada ◽  
Yusuke Chino
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Delayed Diagnosis ◽  
Typical Case

Treatment of Vision Loss in Giant Cell Arteritis

2011 ◽  
Vol 14 (1) ◽  
pp. 84-92 ◽  
Author(s):  
Ryan A. Scheurer ◽  
Andrew R. Harrison ◽  
Michael S. Lee
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss

Survival of patient with giant cell arteritis: Impact of vision loss and treatment with aspirin

2019 ◽  
Vol 18 (8) ◽  
pp. 831-834 ◽  
Author(s):  
Gideon Nesher ◽  
Vladimir Poltorak ◽  
Isam Hindi ◽  
Ronit Nesher ◽  
Yossi Dror ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss

scholarly journals Current advances in the treatment of giant cell arteritis: the role of biologics

2019 ◽  
Vol 11 ◽  
pp. 1759720X1982722 ◽  
Author(s):  
Candice Low ◽  
Richard Conway
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Systemic Vasculitis ◽  
Severe Disease ◽  
Treatment Options ◽  
Biologic Agents ◽  
Necrosis Factor Alpha ◽  
Treatment Paradigm ◽  
High Doses

Giant cell arteritis (GCA) is the most common form of systemic vasculitis. It is a potentially severe disease with 25% of patients suffering vision loss or stroke. Our treatment paradigm is based on glucocorticoids. Glucocorticoids are required in high doses for prolonged periods and subsequently are associated with a significant amount of treatment-related morbidity. Alternative treatment options are urgently needed to minimize these glucocorticoid adverse events. Many other agents, such as methotrexate and tumour necrosis factor alpha inhibitors have been used in GCA, with limited or no evidence of benefit. Our emerging understanding of the pathogenic processes involved in GCA has led to an increased interest in the use of biologic agents to treat the disease. Two randomized controlled trials have recently reported dramatic effects of the use of the interleukin-6 targeted biologic tocilizumab in GCA, with significant increases in remission rates and decreases in glucocorticoid burden. While encouraging, longer-term and additional outcomes are awaited to clarify the exact positioning of tocilizumab in the treatment approach. Emerging data for other biologic agents, particularly abatacept and ustekinumab, are also encouraging but less well advanced. We are at the dawn of a new era in GCA treatment, but uncertainties and opportunities abound.

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