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Year : 2023  |  Volume : 5  |  Issue : 1  |  Page : 3

Giant cell arteritis: Is there a link between ocular and systemic involvement?

1 Department of Ophthalmology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
2 Department of Pathology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal

Correspondence Address:
Mariana G Portela
Rua da Junqueira, 126, 1349-019 Lisbon
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pajo.pajo_65_22

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Introduction: Giant cell arteritis (GCA) is a systemic disease that may cause severe visual loss. Our purpose was to determine which factors contribute to ocular manifestations (OMs) in patients with temporal artery biopsy-proven GCA. Methods: This was a retrospective review of all cases diagnosed in our center from 2010 to 2021 (>6 months follow-up). We analyzed demographic data, comorbidities, type and duration of symptoms before diagnosis, ocular features, and systemic and laboratory findings. Results: Out of 51 patients (60.8% females, mean age 74.8 ± 13.5), 32 (63%) had OM, of whom 28% had transient visual loss, 69% had permanent visual loss, and 9% had diplopia. Apart from scalp tenderness (P = 0.039), OM did not correlate with other ischemic symptoms such as jaw claudication or headache and were even significantly associated with the absence of fever (P = 0.026). Patients with OM also showed lower values of C-reactive protein (CRP) (P = 0.045). Conclusion: In our sample, visual involvement was not significantly associated with any systemic symptom apart from scalp tenderness, which highlights the importance of having a high index of suspicion for GCA in an ophthalmology setting, especially in older patients with visual loss. Furthermore, OMs were significantly associated with the absence of fever and lower values of CRP which may suggest a lower inflammatory state may in these patients.

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