Occult giant cell arteriti: Ocular manifetation Original Reearch Article

Purpoe To report the incidence, viual ymptom, and ocular ign of occult giant cell arteriti in patient who initially preented with viual ymptom and ocular ign of giant cell arteriti. Occult giant cell arteriti wa defined a ocular involvement by giant cell arteriti without any ytemic ymptom and ign of giant cell arteriti. Method In a propective tudy from 1973 to 1995, we invetigated 85 patient who had ocular involvement caued by giant cell arteriti and whoe diagnoi of giant cell arteriti wa confirmed on temporal artery biopy. At the initial viit, patient were quetioned pecifically on ytemic and ocular ymptom and ign of giant cell arteriti at or before the onet of viual diturbance. Erythrocyte edimentation rate (Wetergren) and C-reactive protein level were evaluated before the tart of ytemic corticoteroid therapy. Reult Eighteen (21.2%) of 85 patient had occult giant cell arteriti. There wa no ignificant difference in age and ex ditribution between patient with and without ytemic ymptom of giant cell arteriti. Although both group of patient had abnormal erythrocyte edimentation rate and C-reactive protein level, there wa a ignificant difference in erythrocyte edimentation rate (P <.0001) and C-reactive protein level (P = Concluion Becaue occult giant cell arteriti i a potential caue of blindne, it early diagnoi i the key to preventing blindne; it i important to recognize that 21.2% of patient with giant cell arteriti and viual lo do not have any ytemic ymptom of giant cell arteriti. Thu, in peron older than 55 year, amauroi fugax or viual lo, development of an acute ocular ichemic leion (particularly arteritic anterior ichemic optic neuropathy), and abnormal C-reactive protein level, with or without elevated erythrocyte edimentation rate and ytemic ymptom, hould raie a high index of upicion for giant cell arteriti.