Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;42(2):309-15.
doi: 10.3899/jrheum.140188. Epub 2014 Dec 15.

Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort

Abha G Singh  1 , Tanaz A Kermani  1 , Cynthia S Crowson  1 , Cornelia M Weyand  1 , Eric L Matteson  1 , Kenneth J Warrington  2
Affiliations

Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort

Abha G Singh et al. J Rheumatol. 2015 Feb.

Abstract

Objective: To evaluate clinical characteristics, treatment, and outcomes of patients with visual changes from giant cell arteritis (GCA) and to examine trends over the last 5 decades.

Methods: We reviewed the medical records of a population-based cohort of patients with GCA diagnosed between 1950 and 2004. The clinical, ophthalmological, and laboratory features of patients with visual manifestations attributable to GCA were compared to patients without visual complications. Trends over time were examined using logistic regression modeling adjusted for age and sex.

Results: In a cohort of 204 cases of GCA (mean age 76.0 ± 8.2 yrs, 80% female), visual changes from GCA were observed in 47 patients (23%), and 4.4% suffered complete vision loss. A higher proportion of patients with visual manifestations reported jaw claudication than did patients without visual changes (55% vs 38%, p = 0.04). Over a period of 55 years, we observed a significant decline in the incidence of visual symptoms due to GCA. There was a lower incidence of ischemic optic neuropathy in the 1980-2004 cohort vs 1950-1979 (6% vs 15%, p = 0.03). Patients diagnosed in later decades were more likely to recover from visual symptoms (HR 1.34, 95% CI 1.06-1.71). Chances of recovery were poor in patients with anterior ischemic optic neuropathy or complete vision loss.

Conclusion: Incidence of visual symptoms has declined over the past 5 decades, and chances of recovery from visual symptoms have improved. However, complete loss of vision is essentially irreversible. Jaw claudication is associated with higher likelihood of development of visual symptoms.

Keywords: BLINDNESS; GIANT CELL ARTERITIS; STEROIDS; VASCULITIS; VISION LOSS; VISUAL MANIFESTATIONS.

PubMed Disclaimer

Conflict of interest statement

Disclosures: None of the authors had any conflicts of interest.

Figures

Figure 1
Figure 1
The incidence of visual manifestations (adjusted for age and sex) among 204 patients with giant cell arteritis, in Olmsted County, MN between 1950 and 2004, declined over time (p=0.02). Point estimate and 95% confidence interval for each 5 year time period are displayed.
See this image and copyright information in PMC

References

    1. Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008;372:234–245. - PubMed
    1. Horton BT, Magath TB, Brown GE. Undescribed Form of Arteritis of Temporal Vessels. Proc. Staff Meet. Mayo Clin. 1932;7:700–701.
    1. Paulley JW, Hughes JP. Giant-cell arteritis, or arteritis of the aged. Br Med J. 1960;2:1562–1567. - PMC - PubMed
    1. Kermani TA, Schafer VS, Crowson CS, Hunder GG, Gabriel SE, Matteson EL, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010;69:780–781. - PubMed
    1. Salvarani C, Crowson CS, O'Fallon WM, Hunder GG, Gabriel SE. Reappraisal of the epidemiology of giant cell arteritis in Olmsted County, Minnesota, over a fifty-year period. Arthritis Rheum. 2004;51:264–268. - PubMed

Publication types

Substances