• AION and Other Causes of Vision Loss From Giant Cell Arteritis

    By Marianne Doran and edited by Susan M. MacDonald, MD

    Journal Highlights

    Ophthalmology, September 2016

    Chen et al.
    studied the causes and incidence of permanent vision loss from giant cell arteritis (GCA). They found that the most common cause was arteritic ischemic optic neuropathy (AION) and that visual outcomes were poor among patients with GCA-related vision loss.

    In this retrospective population-based cohort study, the investigators examined all residents of Olmsted County, Minn., who had been diag­nosed with GCA between Jan. 1, 1950, and Dec. 31, 2009. These patients were identified through the Roches­ter Epidemiology Project, a medical record–linkage system used for all patient encounters in Olmsted County. Medical records identified the cause of permanent vision loss from GCA as well as the patients’ systemic symptoms of GCA and visual outcomes. Primary outcome measures were incidence and degree of permanent vision loss from GCA.

    Among the 245 new cases of GCA over the 60-year period, 20 patients (8.2%) experienced permanent vision loss due to GCA. The incidence of AION was 6.9% and accounted for 85% of cases of permanent vision loss. The incidence of central retinal artery occlusion (CRAO) was 1.6%, and that of cilioretinal artery occlusion was 0.4%. In addition, the population- based age- and sex-adjusted annual incidence of AION from GCA among individuals ≥50 years was 1.3 per 100,000 population.

    The presenting visual acuities in patients with AION or CRAO ranged from 20/20 to no light perception; 73% of patients had 20/200 or worse. Overall, there were no significant differences between the presenting and final visual acuities. One of the notable findings in this study was that 20% of patients who experienced GCA-related permanent visual loss did not have sys­temic symptoms.

    The researchers conclud­ed that population-based data provide the most accu­rate incidence of permanent vision loss from GCA. The study also confirmed that visual outcomes from GCA-related vision loss are poor and that permanent vision loss from GCA may occur even in the absence of con­stitutional symptoms.

    The original article can be found here.