RT Journal Article
SR Electronic
T1 Visual Manifestations in Giant Cell Arteritis: Trend over 5 Decades in a Population-based Cohort
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.140188
DO 10.3899/jrheum.140188
A1 Abha G.  Singh
A1 Tanaz A.  Kermani
A1 Cynthia S.  Crowson
A1 Cornelia M.  Weyand
A1 Eric L.  Matteson
A1 Kenneth J.  Warrington
YR 2014
UL http://www.jrheum.org/content/early/2014/12/10/jrheum.140188.abstract
AB Objective To evaluate clinical characteristics, treatment, and outcomes of patients with visual changes from giant cell arteritis (GCA) and to examine trends over the last 5 decades. Methods We reviewed the medical records of a population-based cohort of patients with GCA diagnosed between 1950 and 2004. The clinical, ophthalmological, and laboratory features of patients with visual manifestations attributable to GCA were compared to patients without visual complications. Trends over time were examined using logistic regression modeling adjusted for age and sex. Results In a cohort of 204 cases of GCA (mean age 76.0 ± 8.2 yrs, 80% female), visual changes from GCA were observed in 47 patients (23%), and 4.4% suffered complete vision loss. A higher proportion of patients with visual manifestations reported jaw claudication than did patients without visual changes (55% vs 38%, p = 0.04). Over a period of 55 years, we observed a significant decline in the incidence of visual symptoms due to GCA. There was a lower incidence of ischemic optic neuropathy in the 1980–2004 cohort vs 1950–1979 (6% vs 15%, p = 0.03). Patients diagnosed in later decades were more likely to recover from visual symptoms (HR 1.34, 95% CI 1.06–1.71). Chances of recovery were poor in patients with anterior ischemic optic neuropathy or complete vision loss. Conclusion Incidence of visual symptoms has declined over the past 5 decades, and chances of recovery from visual symptoms have improved. However, complete loss of vision is essentially irreversible. Jaw claudication is associated with higher likelihood of development of visual symptoms.