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Berger T, Xanthopoulou K, Zemova E, et al. Simultaner bilateraler primärer Verschluss der A. ophthalmica aufgrund einer floriden Riesenzellarteriitis. Simultaneous Bilateral Primary Occlusion of the Ophthalmic Artery due to Florid Giant Cell Arteritis. Klin Monbl Augenheilkd. 2021;doi: 10.1055/a-1554-5182.
Berger, T., Xanthopoulou, K., Zemova, E., Bohle, R. M., Seitz, B., & Abdin, A. (2021). Simultaner bilateraler primärer Verschluss der A. ophthalmica aufgrund einer floriden Riesenzellarteriitis. Simultaneous Bilateral Primary Occlusion of the Ophthalmic Artery due to Florid Giant Cell Arteritis. Klinische Monatsblatter fur Augenheilkunde, . https://doi.org/10.1055/a-1554-5182
Berger, Tim, et al. "Simultaner bilateraler primärer Verschluss der A. ophthalmica aufgrund einer floriden Riesenzellarteriitis." Simultaneous Bilateral Primary Occlusion of the Ophthalmic Artery due to Florid Giant Cell Arteritis. Klinische Monatsblatter fur Augenheilkunde vol. (2021). doi: https://doi.org/10.1055/a-1554-5182
Berger T, Xanthopoulou K, Zemova E, Bohle RM, Seitz B, Abdin A. Simultaner bilateraler primärer Verschluss der A. ophthalmica aufgrund einer floriden Riesenzellarteriitis. Simultaneous Bilateral Primary Occlusion of the Ophthalmic Artery due to Florid Giant Cell Arteritis. Klin Monbl Augenheilkd. 2021 Aug 11; doi: 10.1055/a-1554-5182. Epub 2021 Aug 11. PMID: 34380160.
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Klin Monbl Augenheilkd. 2021 Aug 11; doi: 10.1055/a-1554-5182. Epub 2021 Aug 11.

Simultaneous Bilateral Primary Occlusion of the Ophthalmic Artery due to Florid Giant Cell Arteritis.

Klinische Monatsblatter fur Augenheilkunde

Tim Berger, Kassandra Xanthopoulou, Elena Zemova, Rainer M Bohle, Berthold Seitz, Alaadin Abdin

Affiliations

  1. Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Homburg (Saar), Germany.
  2. Institut für Allgemeine und Spezielle Pathologie, Universitätsklinikum des Saarlandes (UKS), Homburg (Saar), Germany.

PMID: 34380160 DOI: 10.1055/a-1554-5182

Abstract

PURPOSE: To report a case of simultaneous bilateral ophthalmic artery occlusion in diagnosed giant cell arteritis (GCA).

OBSERVATIONS: A 77-year-old male patient presented to the emergency department with simultaneous vision loss in both eyes for 3 hours. Headache at both temples and jaw claudication had been present for 3 weeks. Laboratory values demonstrated an initially increased C-reactive protein (CRP) of 202.0 mg/L and an erythrocyte sedimentation rate (ESR) of 100 mm within the first 20 minutes. Duplex sonography of the right and left temporal arteries revealed a "halo sign." A case of GCA was suspected, and intravenous high-dose methylprednisolone therapy was immediately administered. The clinical examination revealed a bilateral central retinal artery occlusion and fluorescein angiography showed a hot optic disc in the right eye and patchy choroidal hypoperfusion in both eyes. Biopsy of the left temporal artery was performed, which confirmed a florid temporal arteritis with complete thrombotic occlusion of the vascular lumen. Despite a good response to the administered therapy (CRP 17.0 mg/L 1 week after initiation), the visual prognosis was significantly limited through retinal and optic nerve involvement. By the follow-up examination 8 weeks later, the near visual acuity was 20/400 in the right and left eye at a distance of 16 inches.

CONCLUSION AND IMPORTANCE: We hereby present a simultaneous bilateral ophthalmic artery occlusion as a rare complication of GCA. The combination of central retinal artery occlusion, arteritic anterior ischemic optic neuropathy, and choroidal hypoperfusion suggests an acute inflammatory involvement of the ophthalmic artery. In cases of the slightest suspicion of giant cell arteritis, an immediate high-dose steroid therapy initiation is of utmost importance.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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