Orbital magnetic resonance imaging to unmask giant cell arteritis

Alcalá, E. Serrano; Isern, E. Grivé; Borras, L. Díez; Díaz, JJ

doi:10.1016/j.rxeng.2020.02.003

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Affected vessels are typically identified by wall thickening and mural contrast enhancement. Interestingly, numerous case reports [37][38][39][40][41][42][43][44] and systematic investigations [45][46][47] have described arteritic involvement of the ophthalmic and posterior ciliary arteries, as well as perineural enhancement (PNE) of the optic nerve in GCA patients with ION. However, the studies available suggest that the aforementioned imaging features can be observed in eyes of GCA patients unaffected by vision loss 38,43,[45][46][47] .…”

Section: Discussionmentioning

confidence: 99%

Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Danyel

Miszczuk

Pietrock

et al. 2022

Sci Rep

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This study assessed diffusion abnormalities of the optic nerve (ON) in giant cell arteritis (GCA) patients with acute onset of visual impairment (VI) using diffusion-weighted magnetic resonance imaging (DWI). DWI scans of GCA patients with acute VI were evaluated in a case-control study. Two blinded neuroradiologists assessed randomized DWI scans of GCA and controls for ON restricted diffusion. Statistical quality criteria and inter-rater reliability (IRR) were calculated. DWI findings were compared to ophthalmological assessments. 35 GCA patients (76.2 ± 6.4 years; 37 scans) and 35 controls (75.7 ± 7.6 years; 38 scans) were included. ON restricted diffusion was detected in 81.1% (Reader 1) of GCA scans. Localization of ON restricted diffusion was at the optic nerve head in 80.6%, intraorbital in 11.1% and affecting both segments in 8.3%. DWI discerned affected from unaffected ON with a sensitivity, specificity, positive and negative predictive value of 87%/99%/96%/96%. IRR for ON restricted diffusion was κinter = 0.72 (95% CI 0.59–0.86). DWI findings challenged ophthalmologic diagnoses in 4 cases (11.4%). DWI visualizes anterior and posterior ON ischemia in GCA patients with high sensitivity and specificity, as well as substantial IRR. DWI may complement the ophthalmological assessment in patients with acute VI.

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Section: Discussionmentioning

confidence: 99%

Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Danyel

Miszczuk

Pietrock

et al. 2022

Sci Rep

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Orbital magnetic resonance imaging of giant cell arteritis with ocular manifestations: a systematic review and individual participant data meta-analysis

et al. 2023

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Orbital Aspergillosis Mimicking Giant Cell Arteritis

Bastion¹

2021

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Orbital aspergillosis is a very rare, debilitating disease which can present solely with painful optic neuropathy and mimic giant cell arteritis in an elderly person. We report a case of orbital aspergillosis in a 65-year-old Malay man who presented with unilateral gradual blurring of vision and ipsilateral headache. Our initial working diagnosis was giant cell arteritis. Unfortunately, patient’s condition worsened with intravenous corticosteroid and developed into orbital apex syndrome. Imaging and biopsy results showed evidence of orbital aspergillosis. Patient lost his eyesight due to the wrong initial working diagnosis. This report is to emphasize that although giant cell arteritis is also a sight and life-threatening condition, it is rare among Asian populations. We need to take into account the epidemiology of the disease and look into any other differential diagnoses when the presentation is atypical.

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Orbital magnetic resonance imaging to unmask giant cell arteritis

Cited by 3 publications

References 8 publications

Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Orbital magnetic resonance imaging of giant cell arteritis with ocular manifestations: a systematic review and individual participant data meta-analysis

Orbital Aspergillosis Mimicking Giant Cell Arteritis

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