Giant Cell Arteritis Diagnosis and Treatment
If you have vision problems, your ophthalmologist will give you a detailed eye examination. He or she will check your visual acuity and measure your eye pressure. Your ophthalmologist will also give you a dilated eye examination to look for signs of damage to the optic nerve or retina. Your doctor also will examine your head. Touching the head may show that the scalp is sensitive and has a tender, thick artery on one side. The affected artery may have a weak pulse or no pulse.
Your doctor will order blood tests. While the tests cannot confirm if you have giant cell arteritis (GCA), they can show whether your body has inflammation (swelling). If the blood tests are normal, you probably do not have GCA. If the blood tests are abnormal, you will need a biopsy (sample of tissue) taken from your temple artery to confirm the findings of the blood tests. If there is inflammation in the artery, you will need steroid treatment.
Your doctor may order imaging tests, such as an MRI, to check the health of your arteries. You may also have a visual field test to see if you have lost any peripheral (side) vision.
How is GCA treated?
Your doctor will likely prescribe steroid tablets for you to take. Your doctor may not wait until he or she confirms you have GCA to give you steroid tablets. It is important to treat GCA as soon as possible to prevent vision loss. Many people feel better soon after starting treatment, but the treatment can last as long as two years.
If you have lost vision from GCA, your vision will likely stabilize once you start the steroids. However, any vision loss you already have may be permanent. In such cases, learning to make the most of your remaining vision will help you keep your independence.
You will need to be carefully monitored by your doctor while you are on this medication. Steroid medications can have side effects, including increasing your chance of broken bones.
There is also another medicine (tocilizumab) now approved by the FDA to treat GCA. This medicine is given by injection and can be done at the doctor’s office or on your own at home. Tocilizumab may not be the right medicine for people who have had certain infections or diseases. Talk to your doctor to see if you are a good candidate for this medicine.