Large-Vessel Vasculitis in Ophthalmology: Giant Cell Arteritis and Takayasu Arteritis

Abstract

Giant cell arteritis and Takayasu arteritis are large-vessel vasculitides that share multiple common features but also have significant differences in epidemiology, demographics, clinical presentation, evaluation, and treatment. Giant cell arteritis is more common in elderly patients of Caucasian descent versus Takayasu arteritis, which is more prevalent in younger patients of Asian descent. Although traditionally age has been the main criterion for differentiating the 2 etiologies, modifications in the diagnostic criteria have recognized the overlap between the 2 conditions. In this monograph, we review the diagnostic criteria for both conditions and describe the epidemiology, pathogenesis, histology, evaluation, and management for large-vessel vasculitis in ophthalmology. Additionally, we describe ocular imaging techniques that may be utilized by ophthalmologists to identify manifestations of large-vessel vasculiti- des in patients. Lastly, we compare and contrast the key clinical, laboratory, and pathologic features that might help ophthalmologists to differentiate the 2 entities.

Progress in central retinal artery occlusion: a narrative review

“… 1 The most common cause is giant cell arteritis (GCA), an idiopathic vasculitis that mainly affects the head and upper body in older adults; it nearly always leads to stenosis and occlusion of small to medium-sized arteries. 29 Superficial temporal artery biopsy is important for the diagnosis of GCA. Typical features include concentric intimal hyperplasia, disruption of the internal elastic lamina, and infiltration of multinucleated giant cells; notably, the absence of giant cells on biopsy does not exclude the possibility of GCA.…”

The Eye Is a Window to Systemic and Neuro-Ophthalmic Diseases

“…These 2 large vessel vasculitides have a significant degree of overlap, and one diagnostic dilemma is distinguishing between these similar disease processes. In this issue, Lee et al 18 discuss the overlap and the distinguishing epidemiologic, pathologic, and histologic features and differences in management for these large vessels vasculitides.…”