Combined Left Central Retinal Artery Occlusion and Bilateral Anterior Ischemic Optic Neuritis: A Rare Presentation of Giant Cell Arteritis

Abstract

Giant cell arteritis, a large vessel vasculitis is characterized by headache, visual impairment, constitutional symptoms, and increased inflammatory markers. Visual involvement in giant cell arteritis ranges from amaurosis fugax to permanent visual loss, and extensive bilateral visual impairment is a rare presentation. We hereby report a case of combined left central retinal artery occlusion and bilateral anterior ischemic optic neuritis in a patient who poorly responded to standard corticosteroid therapy.

Simultaneous Appearance of Arteritic Anterior Ischemic Optic Neuropathy and Central Retinal Artery Occlusion in Giant Cell Arteritis

“…Fundus examination showed bilateral pale disc and left eye cherry red spot, no documented on optic disc edema. This may suggest an older AAION changes (5). In our case report, simultaneous onset of AAION and CRAO in both eyes was based on patient's complaints, evidence of acute appearance of fundus findings at presentation and the evolving changes during follow up.…”

Bilateral Anterior Ischemic Optic Neuropathy Accompanied with Unilateral Central Retinal Artery Occlusion in a Biopsy-proven Case of Giant Cell Arteritis

“…[4] There has been only one report of a similar presentation of GCA in literature. [5] Although we cannot confirm the similarity of the extent of bilateral involvement between these two cases due to the lack of sufficient angiographic data, both reports have one thing in common, which is neither of these patients has enjoyed vision improvement after pulse corticosteroid therapy. Overall, this report presents an extreme manifestation of GCA with detailed illustrations to emphasize the importance of timely diagnosis and urgent treatment in these patients.…”