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: (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

[thumbnail of Visual involvement in GCA final version(003)]
PDF (Visual involvement in GCA final version(003)) - Accepted Version
Download (318kB) | Preview


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
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:
Depositing User: LivePure Connector
Date Deposited: 22 Oct 2023 01:09
Last Modified: 17 Jul 2024 01:44
DOI: 10.7861/clinmed.2022-0415


Downloads per month over past year

Actions (login required)

View Item View Item