Interesting Image

Giant Cell Arteritis

10.4274/eamr.galenos.2020.08370

• Sunny Chi Lik Au
• Simon Tak Chuen Ko

Received Date: 10.01.2020 Accepted Date: 03.02.2020 Eur Arc Med Res 2020;36(2):159-161

• Abstract
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A 76-year-old lady presented to emergency department for left eye sudden visual loss, and fundoscopy found cherry-red spot over the central macula with attenuated retinal vessels. Central retinal artery occlusion (CRAO) was diagnosed. She did not complain of new onset headache, but mild tenderness on palpation over left temporal area with vaguely weak pulsation detected. After the acute management of CRAO pharmacologically, rebreathing into paper bag, and ocular massage; patient underwent hyperbaric oxygen therapy hoping to salvage the ischemic retina while waiting for the erythrocyte sedimentation rate result. Result was >100 mm/hr, and high dose oral steroid was started immediately. Superficial temporal artery biopsy (TAB), performed 2 days after steroid treatment, was diagnostic of giant cell arteritis (GCA). Positron emission tomography and computerized tomography scan revealed vasculitis over thoracic aorta, left common carotid and subclavian artery. Ocular imaging of CRAO, histology of GCA on TAB are discussed with the interesting images.

Keywords: Giant cell arteritis, central retinal artery occlusion, fundus fluorescein angiography, temporal artery biopsy

Ethics

Informed Consent: Consent form was filled out by all participants.

Peer-review: Externally peer-reviewed.

Concept: S.C.L.A., Design: S.C.L.A., Data Collection or Processing: S.C.L.A., Analysis or Interpretation: S.C.L.A., Literature Search: S.C.L.A., S.T.C.K., Writing: S.C.L.A.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.

Images

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