Frequency of visual involvement in a 10-year interdisciplinary cohort of patients with giant cell arteritis

Mansfield Smith, Sonja C., Al-Hashimi, Mustafa R., Jones, Colin D. and Mukhtyar, Chetan B. ORCID: https://orcid.org/0000-0002-9771-6667 (2023) Frequency of visual involvement in a 10-year interdisciplinary cohort of patients with giant cell arteritis. Clinical Medicine, 23 (3). pp. 206-212. ISSN 1470-2118

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Abstract

BACKGROUND: We present the largest study of the frequency and nature of visual complications in a cohort of 350 patients consecutively diagnosed with giant cell arteritis (GCA). METHODS: All individuals were assessed using structured forms and diagnosed using imaging or biopsy. A binary logistic regression model was used to analyse data for predicting visual loss. RESULTS: Visual symptoms occurred in 101 (28.9%) patients, with visual loss in one or both eyes in 48 (13.7%) patients. Four patients had binocular visual loss. Anterior ischaemic optic neuropathy (N=31), retinal artery obstruction (N=8) and occipital stroke (N=2) were the main causes of visual loss. Of the 47 individuals who had repeat visual acuity testing at 7 days, three individuals had improvement to 6/9 or better. After introducing the fast-track pathway, the frequency of visual loss decreased from 18.7% to 11.5%. Age at diagnosis (odds ratio (OR) 1.12) and headache (OR 0.22) were significant determinants of visual loss in a multivariate model. Jaw claudication trended to significance (OR 1.96, p=0.054). CONCLUSIONS: We recorded a visual loss frequency of 13.7% in the largest cohort of patients with GCA examined from a single centre. Although improvement in vision was rare, a dedicated fast-track pathway reduced visual loss. Headache could result in earlier diagnosis and protect against visual loss.

Item Type:	Article
Additional Information:	Publisher Copyright: © Royal College of Physicians 2023. All rights reserved.
Uncontrolled Keywords:	arteritic anterior ischaemic optic neuropathy,gca fast track pathway,giant cell arteritis,visual loss,visual manifestations,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	22 Oct 2023 01:09
Last Modified:	07 Nov 2023 02:48
URI:	https://ueaeprints.uea.ac.uk/id/eprint/93393
DOI:	10.7861/clinmed.2022-0415

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