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. 2016 Aug;43(8):1559-65.
doi: 10.3899/jrheum.151033. Epub 2016 Jun 1.

Visual Complications in Patients with Biopsy-proven Giant Cell Arteritis: A Population-based Study

Muna Saleh  1 , Carl Turesson  1 , Martin Englund  1 , Peter A Merkel  1 , Aladdin J Mohammad  2
Affiliations

Visual Complications in Patients with Biopsy-proven Giant Cell Arteritis: A Population-based Study

Muna Saleh et al. J Rheumatol. 2016 Aug.

Abstract

Objective: To study the clinical and laboratory characteristics of patients with biopsy-proven giant cell arteritis (GCA) with visual complications, and to evaluate the incidence rate of visual complications in GCA compared to the background population.

Methods: Data from 840 patients with GCA in the county of Skåne, Sweden, diagnosed between 1997 and 2010, were used for this analysis. Cases with visual complications were identified from a diagnosis registry and confirmed by a review of medical records. The rate of visual complications in patients with GCA was compared with an age- and sex-matched reference population.

Results: There were 85 patients (10%) who developed ≥ 1 visual complication after the onset of GCA. Of the patients, 18 (21%) developed unilateral or bilateral complete visual loss. The mean age at diagnosis was 78 years (± 7.3); 69% were women. Compared with patients without visual complications, those with visual complication had lower C-reactive protein levels at diagnosis and were less likely to have headache, fever, and palpable abnormal temporal artery. The use of β-adrenergic inhibitors was associated with visual complications. The incidence of visual complications among patients with GCA was 20.9/1000 person-years of followup compared to 6.9/1000 person-years in the reference population, resulting in a rate ratio of 3.0 (95% CI 2.3-3.8).

Conclusion: Ten percent of patients with GCA developed visual complications, a rate substantially higher than that of the general population. Patients with GCA who had visual complications had lower inflammatory responses and were more likely to have been treated with β-adrenergic inhibitors compared with patients without visual complications.

Keywords: CLINICAL CHARACTERISTICS; GIANT CELL ARTERITIS; INFLAMMATION; RATE RATIO; VISUAL COMPLICATIONS; β-BLOCKERS.

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