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Case Reports
. 2020 Dec;40(4):530-532.
doi: 10.1097/WNO.0000000000000838.

Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects

Mariam Hussain  1 , Ashwini Kini  1 , Bayan Al Othman  1 , Claudia Prospero Ponce  1 , Helen Li  1 , Andrew G Lee  1
Affiliations
Case Reports

Arteritic Orbital Ischemia Producing Afferent and Efferent Pupillary Defects

Mariam Hussain et al. J Neuroophthalmol. 2020 Dec.

Abstract

A 67-year-old woman presented with acute loss of vision to no light perception (NLP), a right afferent pupillary defect, and anisocoria with a nonreactive and dilated pupil in the right eye. Fundus examination showed pallid optic disc edema and a central retinal artery occlusion (CRAO) in the right eye. A temporal artery biopsy showed giant cell arteritis (GCA). Orbital involvement in GCA has been reported previously. However the combination of an afferent and efferent pupillary defect, NLP vision, pallid disc edema, and a CRAO in an elderly patient is likely a unique clinical combination that should strongly suggest GCA. Clinicians should be aware of the myriad presentations of GCA, including orbital ischemia.

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References

    1. Wilkinson IM, Russell RW. Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement. Arch Neurol. 1972;27:378–391.
    1. Williams ZR, Wang X, Diloreto DA. Central retinal artery occlusion with subsequent central retinal vein occlusion in biopsy-proven giant cell arteritis. J Neuroophthalmol. 2016;36:290–291.
    1. Patel HR, Margo CE. Pathology of ischemic optic neuropathy. Arch Pathol Lab Med. 2017;141:162–166.
    1. Hayreh SS, Podhajsky PA, Zimmerman B. Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998;125:509–520.
    1. Chen JJ, Leavitt JA, Fang C, Crowson CS, Matteson EL, Warrington KJ. Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis. Ophthalmology. 2016;123:1999–2003.

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