Thoughts From Your Colleagues
Regarding “Weighed Down by an Anchor”
We recently had the pleasure of reading “Weighed Down by an Anchor” (Morning Rounds, March). The patient presentation was clear and succinct, but the photomicrographs in figures 3A and 3B range from poorly illustrative to incorrect.
Although a diagnosis of giant cell arteritis (GCA) may be established based on clinical features and ancillary laboratory testing, the gold standard for diagnosis is histopathology.1,2 Unfortunately, in this brief report, neither photograph in figure 3 demonstrates the diagnostic granulomatous arteritis or fibrinoid necrosis of the vessel wall that allows for the diagnosis of GCA. If there is evidence of other sections of inflammation in the vascular media, these should have been illustrated in the photos provided in the article.
We are not commenting on whether or not this patient has GCA. We merely seek to make sure that the readers of EyeNet do not get the incorrect impression that the temporal artery findings in these images are diagnostic of GCA.
Vamsee K. Neerukonda, MD
Anna M. Stagner, MD
Thaddeus P. Dryja, MD
Massachusetts Eye & Ear, Boston
1 Cavazza A et al. Am J Surg Pathol. 2014;38(10):1360-1370.
2 Hayreh SS et al. Am J Ophthalmol. 1997;123(3):285-296.
Editors’ note: EyeNet regrets the use of wrong images in the print edition of its March issue and thanks the authors of this month’s letter for identifying the mistake. To view the correct images, see the article at the link above.