Ophthalmologic Manifestations of Giant Cell Arteritis Medication

  • Author: Manolette R Roque, MD, MBA; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jun 15, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Next

Corticosteroids

Class Summary

Have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

View full drug information

Methylprednisolone (Adlone, Medrol, Solu-Medrol, Depo-Medrol, Depopred)

 

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability.

Previous
Next

Immunosuppressant agents

Class Summary

Inhibit key steps in the immune system responsible for inflammatory reactions.

View full drug information

Cyclosporine (Sandimmune, Neoral)

 

Cyclic polypeptide that suppresses some humoral immunity and, to a greater extent, cell-mediated immune reactions such as delayed hypersensitivity, allograft rejection, experimental allergic encephalomyelitis, and graft-vs-host disease for a variety of organs. For children and adults, base dosing on ideal body weight.

Available dosage strengths include 25 mg, 50 mg, 100 mg/mL.

View full drug information

Methotrexate (Folex PFS, Rheumatrex)

 

Unknown mechanism of action in treatment of inflammatory reactions; may affect immune function. Ameliorates symptoms of inflammation (eg, pain, swelling, stiffness).

Adjust dose gradually to attain satisfactory response.

View full drug information

Azathioprine (Imuran)

 

Antagonizes purine metabolism and inhibits synthesis of DNA, RNA, and proteins. May decrease proliferation of immune cells, which results in lower autoimmune activity.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Manolette R Roque, MD, MBA  General Manager, Full Partner, Ophthalmic Consultants Philippines Co.; President and CEO, Chief Refractive Surgeon, EYE REPUBLIC Ophthalmology Clinic; Section Chief, Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center; Section Chief, Ocular Immunology and Uveitis, International Eye Institute, St Luke's Medical Center Global City; Senior Eye Surgeon, The LASIK Surgery Clinic; Director, AMC Eye Center, Alabang Medical Center; President, Philippine Ocular Inflammation Society

Manolette R Roque, MD, MBA is a member of the following medical societies: American Academy of Ophthalmic Executives, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD  Full Partner, Ophthalmic Consultants Philippines Co; Service Chief, Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Asian Hospital and Medical Center; Active Staff, International Eye Institute, St Luke's Medical Center Global City; Visiting Ophthalmologist, AMC Eye Center, Alabang Medical Center

Barbara L Roque, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Philippine Academy of Ophthalmology, Philippine Society of Cataract and Refractive Surgery, and Philippine Society of Pediatric Ophthalmolo

Disclosure: Nothing to disclose.

Elisabetta Miserocchi, MD  Fellow in Immunology and Uveitis Service, Department of Ophthalmology, Harvard Medical School

Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO  Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution

C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Kilbourn Gordon III, MD, FACEP  Urgent Care Physician

Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology and Wilderness Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References

  1. Afshari NA, Afshari MA, Lessell S. Temporal arteritis. Int Ophthalmol Clin. Winter 2001;41(1):151-8. [Medline].

  2. Bhatti MT, Tabandeh H. Giant cell arteritis: diagnosis and management. Curr Opin Ophthalmol. Dec 2001;12(6):393-9. [Medline].

  3. Caselli RJ, Hunder GG. Giant cell (temporal) arteritis. Neurol Clin. Nov 1997;15(4):893-902. [Medline].

  4. Ghanchi FD, Dutton GN. Current concepts in giant cell (temporal) arteritis. Surv Ophthalmol. Sep-Oct 1997;42(2):99-123. [Medline].

  5. Ghosh C. Giant cell arteritis. Ophthalmology. Feb 2002;109(2):221-2. [Medline].

  6. Hunder GG. Giant cell arteritis. Lupus. 1998;7(4):266-9. [Medline].

  7. Miller NR. Giant cell arteritis. J Neuroophthalmol. Sep 2000;20(3):219-20. [Medline].

  8. Moltyaner Y, Tenenbaum J. Temporal arteritis: a review and case history. J Fam Pract. Sep 1996;43(3):294-300. [Medline].

  9. Pineles SL, Arnold AC. Giant cell arteritis. Int Ophthalmol Clin. Fall 2007;47(4):105-19, x. [Medline].

  10. Rahman W, Rahman FZ. Giant cell (temporal) arteritis: an overview and update. Surv Ophthalmol. Sep-Oct 2005;50(5):415-28. [Medline].

  11. Rizzo J. Giant cell arteritis. Lecture presented at: Massachusetts Eye and Ear Infirmary. Boston, Mass; Spring 2000.

  12. Savage CO, Harper L, Cockwell P, et al. ABC of arterial and vascular disease: vasculitis. BMJ. May 13 2000;320(7245):1325-8. [Medline].

  13. Savino PJ. Giant cell arteritis. J Neuroophthalmol. Sep 2000;20(3):221. [Medline].

  14. Su GW, Foroozan R. Update on giant cell arteritis. Curr Opin Ophthalmol. Dec 2003;14(6):332-8. [Medline].

  15. Birkhead NC, Wagener HP, Shick RM. Treatment of temporal arteritis with adrenal corticosteroids: Results in 55 cases in which the lesion was proved at biopsy. JAMA. 1975;163:821.

  16. Brilakis HS, Lee AG. Ophthalmoplegia in treated polymyalgia rheumatica and healed giant cell arteritis. Strabismus. Jun 1998;6(2):71-75. [Medline].

  17. Dababneh A, Gonzalez-Gay MA, Garcia-Porrua C, et al. Giant cell arteritis and polymyalgia rheumatica can be differentiated by distinct patterns of HLA class II association. J Rheumatol. Nov 1998;25(11):2140-5. [Medline].

  18. Elling P, Olsson AT, Elling H. Synchronous variations of the incidence of temporal arteritis and polymyalgia rheumatica in different regions of Denmark; association with epidemics of Mycoplasma pneumoniae infection. J Rheumatol. Jan 1996;23(1):112-9. [Medline].

  19. Epperly TD, Moore KE, Harrover JD. Polymyalgia rheumatica and temporal arthritis. Am Fam Physician. Aug 15 2000;62(4):789-96, 801. [Medline].

  20. Evans JM, Hunder GG. Polymyalgia rheumatica and giant cell arteritis. Clin Geriatr Med. Aug 1998;14(3):455-73. [Medline].

  21. Labbe P, Hardouin P. Epidemiology and optimal management of polymyalgia rheumatica. Drugs Aging. Aug 1998;13(2):109-18. [Medline].

  22. Swannell AJ. Polymyalgia rheumatica and temporal arteritis: diagnosis and management. BMJ. May 3 1997;314(7090):1329-32. [Medline].

  23. Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. Jul 19 2008;372(9634):234-45. [Medline].

  24. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. Aug 1990;33(8):1122-8. [Medline].

  25. Diaz VA, DeBroff BM, Sinard J. Comparison of histopathologic features, clinical symptoms, and erythrocyte sedimentation rates in biopsy-positive temporal arteritis. Ophthalmology. Jul 2005;112(7):1293-8. [Medline].

  26. Heathcote JG. Update in pathology: temporal arteritis and its ocular manifestations. Can J Ophthalmol. Apr 1999;34(2):63-8. [Medline].

  27. Weyand CM, Goronzy JJ. Pathogenic principles in giant cell arteritis. Int J Cardiol. Aug 31 2000;75 Suppl 1:S9-S15; discussion S17-9. [Medline].

  28. Ramstead CL, Patel AD. Giant cell arteritis in a neuro-ophthalmology clinic in Saskatoon, 1998-2003. Can J Ophthalmol. Apr 2007;42(2):295-8. [Medline].

  29. Ostberg G. Temporal arteritis in a large necropsy series. Ann Rheum Dis. May 1971;30(3):224-35. [Medline].

  30. Bosley TM, Riley FC. Giant cell arteritis in Saudi Arabia. Int Ophthalmol. 1998;22(1):59-60. [Medline].

  31. Artal NM, Rodriguez M, Luna JD, et al. Giant cell arteritis in a Hispanic population. Ophthalmology. Oct 2002;109(10):1757; discussion 1757. [Medline].

  32. Biousse V, Trobe JD. Transient monocular visual loss. Am J Ophthalmol. Oct 2005;140(4):717-21. [Medline].

  33. Calguneri M, Cobankara V, Ozatli D. Is visual loss due to giant cell arteritis reversible?. Yonsei Med J. Feb 2003;44(1):155-8. [Medline].

  34. Cornblath WT, Eggenberger ER. Progressive visual loss from giant cell arteritis despite high-dose intravenous methylprednisolone. Ophthalmology. May 1997;104(5):854-8. [Medline].

  35. Danesh-Meyer H, Savino PJ, Gamble GG. Poor prognosis of visual outcome after visual loss from giant cell arteritis. Ophthalmology. Jun 2005;112(6):1098-103. [Medline].

  36. Foroozan R, Deramo VA, Buono LM, et al. Recovery of visual function in patients with biopsy-proven giant cell arteritis. Ophthalmology. Mar 2003;110(3):539-42. [Medline].

  37. Gonzalez-Gay MA, Garcia-Porrua C, Llorca J, et al. Visual manifestations of giant cell arteritis. Trends and clinical spectrum in 161 patients. Medicine (Baltimore). Sep 2000;79(5):283-92. [Medline].

  38. Hayreh SS, Zimmerman B. Visual deterioration in giant cell arteritis patients while on high doses of corticosteroid therapy. Ophthalmology. Jun 2003;110(6):1204-15. [Medline].

  39. Kupersmith MJ, Speira R, Langer R, et al. Visual function and quality of life among patients with giant cell (temporal) arteritis. J Neuroophthalmol. Dec 2001;21(4):266-73. [Medline].

  40. Miller NR. Visual manifestations of temporal arteritis. Rheum Dis Clin North Am. Nov 2001;27(4):781-97, vi. [Medline].

  41. Nesher G, Nesher R, Rozenman Y, et al. Visual hallucinations in giant cell arteritis: association with visual loss. J Rheumatol. Sep 2001;28(9):2046-8. [Medline].

  42. Toh ML, Wicks IP. Visual loss as the presenting feature of giant cell arteritis. Aust N Z J Med. Dec 2000;30(6):734. [Medline].

  43. Ali MN, Figueiredo FC. Hoarse voice and visual loss. Br J Ophthalmol. Feb 2005;89(2):240. [Medline].

  44. Connolly BP, Krishnan A, Shah GK, et al. Characteristics of patients presenting with central retinal artery occlusion with and without giant cell arteritis. Can J Ophthalmol. Dec 2000;35(7):379-84. [Medline].

  45. Johnson H, Bouman W, Pinner G. Psychiatric aspects of temporal arteritis: a case report and review of the literature. J Geriatr Psychiatry Neurol. Oct 1997;10(4):142-5. [Medline].

  46. Barbazan C, Gonzalez-Gay MA, Aspe B, et al. Visual recovery after retinal stroke due to giant cell arteritis. Clin Exp Rheumatol. May-Jun 2000;18(3):425-6. [Medline].

  47. Blodi CF. Value of ophthalmologic examination in diagnosing temporal arteritis. JAMA. Mar 27 2002;287(12):1528-9. [Medline].

  48. Danesh-Meyer H, Savino PJ, Spaeth GL, et al. Comparison of arteritis and nonarteritic anterior ischemic optic neuropathies with the Heidelberg Retina Tomograph. Ophthalmology. Jun 2005;112(6):1104-12. [Medline].

  49. Galasso JM, Jay WM. An occult case of giant cell arteritis presenting with combined anterior ischemic optic neuropathy and cilioretinal artery occlusion. Semin Ophthalmol. Sep-Dec 2004;19(3-4):75-7. [Medline].

  50. Hayreh SS. Posterior ischemic optic neuropathy: clinical features, pathogenesis, and management. Eye. Nov 2004;18(11):1188-206. [Medline].

  51. Kim N, Trobe JD, Flint A, et al. Late ipsilateral recurrence of ischemic optic neuropathy in giant cell arteritis. J Neuroophthalmol. Jun 2003;23(2):122-6. [Medline].

  52. Lessell S. Optic neuropathy in giant cell arteritis. J Neuroophthalmol. Sep 2005;25(3):247. [Medline].

  53. McFadzean RM. Ischemic optic neuropathy and giant cell arteritis. Curr Opin Ophthalmol. Dec 1998;9(6):10-7. [Medline].

  54. Patel SJ, Lundy DC. Ocular manifestations of autoimmune disease. Am Fam Physician. Sep 15 2002;66(6):991-8. [Medline].

  55. Rucker JC, Biousse V, Newman NJ. Ischemic optic neuropathies. Curr Opin Neurol. Feb 2004;17(1):27-35. [Medline].

  56. Saha N, Rehman SU. Reversal of chronic ocular ischemia with good visual recovery in giant cell arteritis. Eye. 2005 Jul 1. [Medline].

  57. Schäuble B, Wijman CA, Koleini B, et al. Ophthalmic artery microembolism in giant cell arteritis. J Neuroophthalmol. Dec 2000;20(4):273-5. [Medline].

  58. Schmidt D. Ocular ischemia syndrome - a malignant course of giant cell arteritis. Eur J Med Res. Jun 22 2005;10(6):233-42. [Medline].

  59. Tovilla-Canales JL. Ocular manifestations of giant cell arteritis. Curr Opin Ophthalmol. Dec 1998;9(6):73-9. [Medline].

  60. Wein FB, Miller NR. Unilateral central retinal artery occlusion followed by contralateral anterior ischemic optic neuropathy in giant cell arteritis. Retina. 2000;20(3):301-3. [Medline].

  61. Al-Abdulla NA, Kelley JS, Green WR, et al. Herpes zoster vasculitis presenting as giant cell arteritis with choroidal infarction. Retina. Aug 2003;23(4):567-9. [Medline].

  62. Casson RJ, Fleming FK, Shaikh A, et al. Bilateral ocular ischemic syndrome secondary to giant cell arteritis. Arch Ophthalmol. Feb 2001;119(2):306-7. [Medline].

  63. Velusami P, Doherty M, Gnanaraj L. A case of occult giant cell arteritis presenting with bilateral cotton wool spots. Eye. Jul 2006;20(7):863-4. [Medline].

  64. Borg FA, Salter VL, Dasgupta B. Neuro-ophthalmic complications in giant cell arteritis. Curr Allergy Asthma Rep. Jul 2008;8(4):323-30. [Medline].

  65. Killer HE, Holtz DJ, Kaiser HJ, et al. Diplopia, ptosis, and hepatitis as presenting signs and symptoms of giant cell arteritis. Br J Ophthalmol. Nov 2000;84(11):1319-20. [Medline].

  66. Ahmad I, Zaman M. Bilateral internuclear ophthalmoplegia: an initial presenting sign of giant cell arteritis. J Am Geriatr Soc. Jun 1999;47(6):734-6. [Medline].

  67. Foroozan R, Buono LM, Savino PJ, et al. Tonic pupils from giant cell arteritis. Br J Ophthalmol. Apr 2003;87(4):510-2. [Medline].

  68. Bhatti MT. Scalp necrosis and visual loss due to giant cell arteritis. J Emerg Med. Jul 2001;21(1):67-8. [Medline].

  69. Dudenhoefer EJ, Cornblath WT, Schatz MP. Scalp necrosis with giant cell arteritis. Ophthalmology. Oct 1998;105(10):1875-8. [Medline].

  70. Currey J. Scalp necrosis in giant cell arteritis and review of the literature. Br J Rheumatol. Jul 1997;36(7):814-6. [Medline].

  71. Gravanis MB. Giant cell arteritis and Takayasu aortitis: morphologic, pathogenetic and etiologic factors. Int J Cardiol. Aug 31 2000;75 Suppl 1:S21-33; discussion S35-6. [Medline].

  72. Keung YK, Yung C, Wong JW, et al. Association of temporal arteritis, retinal vasculitis, and xanthomatosis with multiple myeloma: case report and literature review. Mayo Clin Proc. Jul 1998;73(7):657-60. [Medline].

  73. Mehelas TJ. The painful eye: neuro-ophthalmic causes. Clin Geriatr Med. Feb 1999;15(1):113-30, vii. [Medline].

  74. Taylor S, Lightman S. The eye in cardiac and cardiovascular disease. Hosp Med. May 2003;64(5):299-301. [Medline].

  75. Smulders YM, Verhagen DW. Giant cell arteritis causing aortic dissection and acute hypertension. BMJ. Jul 4 2008;337:a426. [Medline].

  76. Weyand CM, Bartley GB. Giant cell arteritis: new concepts in pathogenesis and implications for management. Am J Ophthalmol. Mar 1997;123(3):392-5. [Medline].

  77. Weyand CM, Goronzy JJ. Arterial wall injury in giant cell arteritis. Arthritis Rheum. May 1999;42(5):844-53. [Medline].

  78. Weyand CM, Hafner V, Kaiser M, et al. Giant cell arteritis--a molecular approach to the multiple facets of the syndrome. Ann Med Interne (Paris). Nov 1998;149(7):420-4. [Medline].

  79. Gabriel SE, Espy M, Erdman DD, et al. The role of parvovirus B19 in the pathogenesis of giant cell arteritis: a preliminary evaluation. Arthritis Rheum. Jun 1999;42(6):1255-8. [Medline].

  80. Pache M, Kaiser HJ, Haufschild T. Increased endothelin-1 plasma levels in giant cell arteritis: a report on four patients. Am J Ophthalmol. Jan 2002;133(1):160-2. [Medline].

  81. Brigden M. The erythrocyte sedimentation rate. Still a helpful test when used judiciously. Postgrad Med. May 1998;103(5):257-62, 272-4. [Medline].

  82. Olshaker JS, Jerrard DA. The erythrocyte sedimentation rate. J Emerg Med. Nov-Dec 1997;15(6):869-74. [Medline].

  83. Poole TR, Graham EM, Lucas SB. Giant cell arteritis with a normal ESR and CRP. Eye. Jan 2003;17(1):92-3. [Medline].

  84. Saadeh C. The erythrocyte sedimentation rate: old and new clinical applications. South Med J. Mar 1998;91(3):220-5. [Medline].

  85. Walvick MD, Walvick MP. Giant cell arteritis: laboratory predictors of a positive temporal artery biopsy. Ophthalmology. Jun 2011;118(6):1201-4. [Medline].

  86. Foroozan R, Danesh-Meyer H, Savino PJ, et al. Thrombocytosis in patients with biopsy-proven giant cell arteritis. Ophthalmology. Jul 2002;109(7):1267-71. [Medline].

  87. Brannan SO, Cheung D, Murray PI, et al. The use of magnetic resonance imaging in the diagnosis of suspected giant cell arteritis. Br J Ophthalmol. Dec 2004;88(12):1595-6. [Medline].

  88. Cockerham KP, Cockerham GC, Brown HG, et al. Radiosensitive orbital inflammation associated with temporal arteritis. J Neuroophthalmol. Jun 2003;23(2):117-21. [Medline].

  89. Garcia-Porrua C, Santamarina R, Armesto V, et al. Magnetic resonance imaging in optic neuritis due to giant cell arteritis. Arthritis Rheum. Apr 15 2005;53(2):313-4. [Medline].

  90. Khoury JA, Hoxworth JM, Mazlumzadeh M, et al. The Clinical Utility of High Resolution Magnetic Resonance Imaging in the Diagnosis of Giant Cell Arteritis: A Critically Appraised Topic. Neurologist. Sep 2008;14(5):330-335. [Medline].

  91. Murgatroyd H, Nimmo M, Evans A, et al. The use of ultrasound as an aid in the diagnosis of giant cell arteritis: a pilot study comparing histological features with ultrasound findings. Eye. Apr 2003;17(3):415-9. [Medline].

  92. Roters S, Szurman P, Engels BF, et al. The suitability of the ultrasound biomicroscope for establishing texture in giant cell arteritis. Br J Ophthalmol. Aug 2001;85(8):946-8. [Medline].

  93. Albertini JG, Ramsey ML, Marks VJ. Temporal artery biopsy in a dermatologic surgery practice. Dermatol Surg. Jun 1999;25(6):501-8. [Medline].

  94. Ball J, Malhotra R. Efficacy of unilateral versus bilateral temporal artery biopsies for the diagnosis of giant cell arteritis. Am J Ophthalmol. Apr 2000;129(4):559-60. [Medline].

  95. Boyev LR, Miller NR, Green WR. Efficacy of unilateral versus bilateral temporal artery biopsies for the diagnosis of giant cell arteritis. Am J Ophthalmol. Aug 1999;128(2):211-5. [Medline].

  96. Danesh-Meyer HV, Savino PJ, Eagle RC Jr, et al. Low diagnostic yield with second biopsies in suspected giant cell arteritis. J Neuroophthalmol. Sep 2000;20(3):213-5. [Medline].

  97. Fong K, Ferguson V. Surgical performance for specialties undertaking temporal artery biopsies: who should perform them?. Br J Ophthalmol. Mar 2003;87(3):373-4. [Medline].

  98. Galloway GD, Klebe B, Riordan-Eva P. Surgical performance for specialties undertaking temportal artery biopsies: who should perform them?. Br J Ophthalmol. Feb 2002;86(2):250. [Medline].

  99. Hall JK, Volpe NJ, Galetta SL, et al. The role of unilateral temporal artery biopsy. Ophthalmology. Mar 2003;110(3):543-8; discussion 548. [Medline].

  100. Lee AG. Unilateral temporal artery biopsy. Ophthalmology. Nov 2003;110(11):2263; author reply 2263-4. [Medline].

  101. Lessell S. Bilateral temporal artery biopsies in giant cell arteritis. J Neuroophthalmol. Sep 2000;20(3):220-1. [Medline].

  102. Levin LA. Chapter 98. In: Ophthalmic surgery. Part V Ophthalmic Plastic Surgery. 1606-12.

  103. Lie JT. Temporal artery biopsy diagnosis of giant cell arteritis: lessons from 1109 biopsies. Anat Pathol. 1996;1:69-97. [Medline].

  104. Lie JT. Temporal artery biopsy diagnosis of giant cell arteritis: lessons from 1109 biopsies. Anat Pathol. 1996;1:69-97. [Medline].

  105. Macrae M, Tey A. Temporal artery biopsy in ophthalmology: a useful investigation. QJM. May 2006;99(5):350. [Medline].

  106. Murgatroyd H, Milne A. Positive temporal artery biopsy in a patient on therapeutic doses of steroids for six years. Eye. Apr 2001;15(Pt 2):250-1. [Medline].

  107. Pless M, Rizzo JF 3rd, Lamkin JC, et al. Concordance of bilateral temporal artery biopsy in giant cell arteritis. J Neuroophthalmol. Sep 2000;20(3):216-8. [Medline].

  108. Ray-Chaudhuri N, Kine DA, Tijani SO, et al. Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis. Br J Ophthalmol. May 2002;86(5):530-2. [Medline].

  109. Riordan-Eva P, Landau K, O'Day J. Temporal artery biopsy in the management of giant cell arteritis with neuro-ophthalmic complications. Br J Ophthalmol. Oct 2001;85(10):1248-51. [Medline].

  110. Taylor-Gjevre R, Vo M, Shukla D. Temporal artery biopsy for giant cell arteritis. J Rheumatol. Jul 2005;32(7):1279-82. [Medline].

  111. van der Straaten D, Rajakulenthiran M, McKelvie PA, et al. A case of biopsy-negative temporal arteritis--diagnostic challenges. Surv Ophthalmol. Nov-Dec 2004;49(6):603-7. [Medline].

  112. O'Brien JP, Regan W. Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the skin and of temporal arteritis. J Am Acad Dermatol. Feb 1999;40(2 Pt 1):214-22. [Medline].

  113. Weyand CM, Fulbright JW, Hunder GG, et al. Treatment of giant cell arteritis: interleukin-6 as a biologic marker of disease activity. Arthritis Rheum. May 2000;43(5):1041-8. [Medline].

  114. Chan CC, O'Day J. Oral and intravenous steroids in giant cell arteritis. Clin Experiment Ophthalmol. Jun 2003;31(3):179-82. [Medline].

  115. Chan CC, Paine M, O'Day J. Steroid management in giant cell arteritis. Br J Ophthalmol. Sep 2001;85(9):1061-4. [Medline].

  116. Danesh-Meyer H. Giant cell arteritis: managing the ophthalmic medical emergency. Clin Experiment Ophthalmol. Jun 2003;31(3):173-5. [Medline].

  117. Diamond ML. Emergency department management of the acute headache. Clin Cornerstone. 1999;1(6):45-54. [Medline].

  118. Gatenby PA. Vasculitis--diagnosis and treatment. Aust N Z J Med. Oct 1999;29(5):662-77. [Medline].

  119. Hayreh SS. Steroid therapy for visual loss in patients with giant-cell arteritis. Lancet. May 6 2000;355(9215):1572-3. [Medline].

  120. Hayreh SS, Zimmerman B. Management of giant cell arteritis. Our 27-year clinical study: new light on old controversies. Ophthalmologica. Jul-Aug 2003;217(4):239-59. [Medline].

  121. Hayreh SS, Zimmerman B, Kardon RH. Visual improvement with corticosteroid therapy in giant cell arteritis. Report of a large study and review of literature. Acta Ophthalmol Scand. Aug 2002;80(4):355-67. [Medline].

  122. Meskimen S, Cook TD, Blake RL Jr. Management of giant cell arteritis and polymyalgia rheumatica. Am Fam Physician. Apr 1 2000;61(7):2061-8, 2073. [Medline].

  123. Niederkohr RD, Levin LA. Management of the patient with suspected temporal arteritis a decision-analytic approach. Ophthalmology. May 2005;112(5):744-56. [Medline].

  124. Pipitone N, Boiardi L, Salvarani C. Are steroids alone sufficient for the treatment of giant cell arteritis?. Best Pract Res Clin Rheumatol. Apr 2005;19(2):277-92. [Medline].

  125. Spiera RF, Kupersmith M, Paget S, et al. Vision loss in giant cell arteritis patients treated with alternate-day corticosteroids: comment on the article by Hoffman et al. Arthritis Rheum. Apr 2003;48(4):1159-60; author reply 1160-1. [Medline].

  126. Staunton H, Stafford F, Leader M, et al. Deterioration of giant cell arteritis with corticosteroid therapy. Arch Neurol. Apr 2000;57(4):581-4. [Medline].

  127. Zborowska B, Ell J, McGhee-Collett M, et al. Progressive visual loss in a patient with presumed temporal arteritis despite treatment: how to make the diagnosis. Clin Experiment Ophthalmol. Jun 2004;32(3):335-6. [Medline].

  128. Bevis T, Ratnakaram R, Smith MF, et al. Visual loss due to central serous chorioretinopathy during corticosteroid treatment for giant cell arteritis. Clin Experiment Ophthalmol. Aug 2005;33(4):437-9. [Medline].

  129. Chan CC, Paine M, O'day J. Predictors of recurrent ischemic optic neuropathy in giant cell arteritis. J Neuroophthalmol. Mar 2005;25(1):14-7. [Medline].

  130. Nesher G, Berkun Y, Mates M, et al. Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum. Apr 2004;50(4):1332-7. [Medline].

  131. Poole TR, Graham EM. Ocular manifestations of rheumatologic disorders. Curr Opin Ophthalmol. Dec 1999;10(6):458-63. [Medline].

  132. Neff AG, Greifenstein EM. Giant cell arteritis update. Semin Ophthalmol. Jun 1999;14(2):109-12. [Medline].

  133. Schmidt WA, Moll A, Seifert A, et al. Prognosis of large-vessel giant cell arteritis. Rheumatology (Oxford). Sep 2008;47(9):1406-8. [Medline].

  134. Mikanowicz CK, Leslie M. Polymyalgia rheumatica and temporal arteritis: a case presentation. Nurs Clin North Am. Mar 2000;35(1):245-52. [Medline].

  135. Bandini F, Benedetti L, Ceppa P, et al. Uveitis as a presenting sign of giant cell arteritis. J Neuroophthalmol. Sep 2005;25(3):247-8. [Medline].

  136. Buono LM, Foroozan R, de Virgiliis M, et al. Heparin therapy in giant cell arteritis. Br J Ophthalmol. Feb 2004;88(2):298-301. [Medline].

  137. Cotch MF. The socioeconomic impact of vasculitis. Curr Opin Rheumatol. Jan 2000;12(1):20-3. [Medline].

  138. de Heide LJ, Talsma MA. Giant-cell arteritis presenting as an orbital pseudotumor. Neth J Med. Oct 1999;55(4):196-8. [Medline].

  139. Gros F, Maillefert JF, Behin A, et al. Giant cell arteritis with ocular complications discovered simultaneously in two sisters. Clin Rheumatol. 1998;17(1):58-61. [Medline].

  140. Huna-Baron R, Mizrachi IB, Glovinsky Y. Intraocular pressure is low in eyes with giant cell arteritis. J Neuroophthalmol. Dec 2006;26(4):273-5. [Medline].

  141. Islam N, Asaria R, Plant GT, et al. Giant cell arteritis mimicking idiopathic orbital inflammatory disease. Eur J Ophthalmol. May 2003;13(4):392-4. [Medline].

  142. Lee AG, Brazis PW. Temporal arteritis: a clinical approach. J Am Geriatr Soc. Nov 1999;47(11):1364-70. [Medline].

  143. Lee AG, Tang RA, Feldon SE, et al. Orbital presentations of giant cell arteritis. Graefes Arch Clin Exp Ophthalmol. Jul 2001;239(7):509-13. [Medline].

  144. Lincoff NS, Erlich PD, Brass LS. Thrombocytosis in temporal arteritis rising platelet counts: a red flag for giant cell arteritis. J Neuroophthalmol. Jun 2000;20(2):67-72. [Medline].

  145. Nadeau SE. What is vasculitis?. J Neuroophthalmol. Jun 2003;23(2):113-6. [Medline].

  146. Rajesh CV, Cole M. Panuveitis as a presenting feature of giant cell arteritis. Br J Ophthalmol. Mar 2000;84(3):340. [Medline].

 
Previous
Next
 
Hematoxylin and eosin stain, low power. Temporal artery. Note the thrombosis in the lumen, intimal hyperplasia, and infiltration of the arterial wall muscular layers with inflammatory cells. A multinucleated giant cell is seen internal to the muscularis at the area of the internal elastic lamina (upper right).
Anterior ischemic optic neuropathy. Image courtesy of Richard Kho, MD, Q.C. Eye Center, Quezon City, Philippines.
Branch retinal vein occlusion in a patient with giant cell arteritis. Image courtesy of Manolette Roque, MD, Ophthalmic Consultants Philippines Co., EYE REPUBLIC Ophthalmology Clinic, Web Atlas of Ophthalmology.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.