TY - JOUR
T1 - Acute vision loss and choroidal filling delay in the absence of giant-cell arteritis
AU - Bei, Ling
AU - Lee, Iris
AU - Lee, Michael S.
AU - Van Stavern, Greg P.
AU - McClelland, Collin M.
N1 - Publisher Copyright:
© 2016 Bei et al.
PY - 2016/9/13
Y1 - 2016/9/13
N2 - Giant-cell arteritis (GCA) is a visually devastating disease that often progresses to severe bilateral vision loss if untreated. Diagnosis of GCA is made challenging by the protean nature of the disease and the lack of a simple test that is both highly sensitive and specific. Choroidal filling delay on fluorescein angiography (FA) has been touted as a highly characteristic feature of GCA-related vision loss, although knowledge of both the sensitivity and specificity of this finding remains unproven. We report our experience of delayed choroidal filling on FA in a series of seven patients referred to an academic neuro-ophthalmology practice due to concern for GCA. Despite the FA findings, our examination, diagnostic testing, and long-term follow-up excluded the diagnosis of GCA in all cases, suggesting that choroidal perfusion abnormalities may occur in the absence of GCA. When evaluating a patient for acute vision loss, the astute clinician must remain cognizant of the limitations of FA in the diagnosis of GCA.
AB - Giant-cell arteritis (GCA) is a visually devastating disease that often progresses to severe bilateral vision loss if untreated. Diagnosis of GCA is made challenging by the protean nature of the disease and the lack of a simple test that is both highly sensitive and specific. Choroidal filling delay on fluorescein angiography (FA) has been touted as a highly characteristic feature of GCA-related vision loss, although knowledge of both the sensitivity and specificity of this finding remains unproven. We report our experience of delayed choroidal filling on FA in a series of seven patients referred to an academic neuro-ophthalmology practice due to concern for GCA. Despite the FA findings, our examination, diagnostic testing, and long-term follow-up excluded the diagnosis of GCA in all cases, suggesting that choroidal perfusion abnormalities may occur in the absence of GCA. When evaluating a patient for acute vision loss, the astute clinician must remain cognizant of the limitations of FA in the diagnosis of GCA.
KW - Delayed choroidal filling
KW - Fluorescein angiography
KW - Giant-cell arteritis
UR - http://www.scopus.com/inward/record.url?scp=84988715563&partnerID=8YFLogxK
U2 - 10.2147/OPTH.S112196
DO - 10.2147/OPTH.S112196
M3 - Article
C2 - 27695279
AN - SCOPUS:84988715563
SN - 1177-5467
VL - 10
SP - 1573
EP - 1578
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
ER -