May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Retinal Vein Occlusion in Giant Cell Arteritis
Author Affiliations & Notes
  • R.A. Zaldivar
    Internal Medicine, Mayo Clinic, Rochester, MN
  • K.T. Calamia
    Rheumatology,
    Mayo Clinic, Jacksonville, FL
  • J.P. Bolling
    Ophthalmology,
    Mayo Clinic, Jacksonville, FL
  • Footnotes
    Commercial Relationships  R.A. Zaldivar, None; K.T. Calamia, None; J.P. Bolling, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1589. doi:
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      R.A. Zaldivar, K.T. Calamia, J.P. Bolling; Retinal Vein Occlusion in Giant Cell Arteritis . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1589.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:To identify patients with both retinal vein occlusions (branch and central) and giant cell arteritis (GCA) and describe the associated clinical findings. Methods:A retrospective review, using a computerized search, of medical records at the Mayo Clinic over a 25–year period for patients with both biopsy–proven GCA and retinal vein occlusion was performed. We attributed central or branch retinal vein occlusion to GCA if both conditions occurred within one year of each other. The clinical findings and associated patient co–morbidities were reviewed. Results:Twelve patients with both disorders were identified occurring at any time in their life. In six of twelve patients, both disorders were temporally related. Three of the six patients did not have any risk factors for developing retinal vein occlusions. In four patients, central retinal vein occlusion was a presenting manifestation of the disease or occurred within three months of the diagnosis of GCA. All of these patients had an elevated sedimentation rate. Two of six patients had evidence of ischemic optic neuritis, in addition to findings of central retinal vein occlusion, at the time of the diagnosis of GCA. All patients experienced some permanent visual loss as a result of the venous occlusions, alone or together with the ischemic optic neuritis. Conclusions:Giant cell arteritis is a vasculitis which primarily involves large and medium size arteries. The disease has a predilection for elastic–containing branches of the external carotid artery and for the extra–dural branches of the internal carotid artery, including the ophthalmic artery. Whereas other types of vasculitis may exhibit venous involvement, this is highly unusual in GCA. Although arterial inflammation and complications account for visual loss in the vast majority of cases of GCA, retinal vein occlusion may be a rare manifestation of GCA. In patients who present with retinal vein occlusion in the absence of a known association, a careful history for symptoms associated with GCA and examination of temporal arteries should be performed and a sedimentation rate should be considered. A temporal artery biopsy may be necessary to exclude the possibility of associated GCA.

Keywords: vascular occlusion/vascular occlusive disease • blood supply • neuro–ophthalmology: diagnosis 
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