Risk factors for visual loss in giant cell (temporal) arteritis: a prospective study of 174 patients

Liozon, É.; Herrmann, Françoís; Ly, Kim-Heang; Robert, Pierre-Yves; Loustaud, V.; Soria, P.; Vidal, É.

doi:10.1016/s0002-9343(01)00770-7

Cited by 195 publications

(121 citation statements)

References 34 publications

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“…Cranial ischemic complications were reported at presentation in 25% of this group of GCA patients (visual loss in 18% and stroke in 7%). These values are comparable with the rates described in other studies (20,21,23). Regarding cranial ischemic complications developing after initiation of steroid therapy and during followup, the rates of visual loss and CVA in our patients were 5% and 4%, respectively.…”

Section: Discussionsupporting

confidence: 91%

“…Previous studies have suggested that the rate of cranial ischemic complications is inversely related to the intensity of the inflammatory response (10,20,21). Another study showed an increased rate of visual loss in patients with thrombocytosis (21).…”

Section: Discussionmentioning

confidence: 99%

“…Another study showed an increased rate of visual loss in patients with thrombocytosis (21). Patients with ischemia in other cranial tissues, such as that manifested by jaw claudication or scalp necrosis, are also considered to be at increased risk of developing irreversible cranial ischemic complications (10,22).…”

Section: Discussionmentioning

confidence: 99%

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Low‐dose aspirin and prevention of cranial ischemic complications in giant cell arteritis

Nesher¹,

Berkun²,

Mates³

et al. 2004

Arthritis & Rheumatism

368

161

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Objective. Cranial ischemic complications such as cerebrovascular accidents (CVAs) and acute visual loss are among the leading causes of giant cell arteritis (GCA)-related morbidity. In this retrospective study, we evaluated the effect of treatment with low-dose aspirin on the incidence of cranial ischemic complications in GCA.Methods. Charts of 175 consecutive patients in whom GCA was diagnosed between 1980 and 2000 were reviewed for medical data. Data for 166 patients who were followed up for at least 3 months were also available.Results. At the time of the diagnosis of GCA, 36 patients (21%) had already been receiving low-dose aspirin (100 mg/day). In all cases, the indication for this treatment was ischemic heart disease. There were no significant differences between the aspirin-treated and non-aspirin-treated groups regarding the mean age of patients, the male-to-female ratio, duration of GCArelated symptoms, rates of headaches, systemic symptoms, and jaw claudication, and the mean erythrocyte sedimentation rate, hemoglobin count, and platelet count. Cerebrovascular risk factors (hypertension, hyperlipidemia, or diabetes mellitus) were more common in the aspirin-treated group (38.9% versus 20%; P‫؍‬ 0.03). Cranial ischemic complications were diagnosed in 43 patients at presentation: 30 patients had acute visual loss, 11 had CVAs, and 2 had both conditions simultaneously. Only 3 of the aspirin-treated patients (8%) presented with cranial ischemic complications, compared with 40 (29%) of the non-aspirin-treated patients (P ‫؍‬ 0.01). Despite the use of steroid therapy, cranial ischemic complications developed in 14 of the 166 patients followed up for 3 months or longer. However, cranial ischemic complications developed in only 3% of the aspirin-treated patients, compared with 13% of the patients treated with prednisone only (P ‫؍‬ 0.02).Conclusion. These data suggest that low-dose aspirin decreases the rate of visual loss and CVAs in patients with GCA.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Low‐dose aspirin and prevention of cranial ischemic complications in giant cell arteritis

Nesher¹,

Berkun²,

Mates³

et al. 2004

Arthritis & Rheumatism

368

161

View full text Add to dashboard Cite

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“…In our series, the proportion of patients who developed permanent visual loss (19.1%) was similar to that reported by Gonzalez-Gay et al (2,12) and by Cid et al (9) (2,3,9,11). Although geographic and ethnic factors may be implicated in the differences in the incidence of GCA at different latitudes, they do not seem to influence the expression of visual manifestations.…”

Section: Discussionsupporting

confidence: 90%

“…In a study from Spain, the presence of a strong acute-phase response (fever and weight loss, ESR 85 mm/ hour, Hgb Ͻ11 gm/dl) at diagnosis defined a subgroup of patients at very low risk of developing cranial ischemic events (in particular visual loss) (9). Likewise, in the study of Liozon et al (11), patients with visual loss had significantly less marked constitutional symptoms and lower CRP levels. Furthermore, similarly to our study, an increased risk of developing visual loss was observed in patients with thrombocytosis at diagnosis.…”

Section: Discussionmentioning

confidence: 96%

Risk factors for visual loss in an Italian population‐based cohort of patients with giant cell arteritis

Salvarani

Cimino

Macchioni

et al. 2005

Arthritis & Rheumatism

226

106

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Objective. To evaluate the frequency of visual manifestations at presentation in an Italian population-based cohort of patients with biopsy-proven giant cell arteritis (GCA), and to investigate predictors for the development of permanent visual loss. Methods. We identified 136 Reggio Emilia (Italy) residents with biopsy-proven GCA diagnosed between 1986 and 2002. Medical records of these 136 patients were reviewed, and demographic, clinical, and laboratory data were collected.Multivariate analysis with multiple logistic regression models was performed to identify the best predictors of visual loss. Results. Visual manifestations developed in 41 patients (30.1%). Partial or total visual loss was observed in 26 patients (19.1%). Anterior ischemic optic neuropathy was seen in 24 patients

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One Hundred Transient Monocular Central Retinal Artery Occlusions Secondary to Giant Cell Arteritis

Alwitry

Holden²

2003

Arch Ophthalmol

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Risk factors for visual loss in giant cell (temporal) arteritis: a prospective study of 174 patients

Cited by 195 publications

References 34 publications

Low‐dose aspirin and prevention of cranial ischemic complications in giant cell arteritis

Low‐dose aspirin and prevention of cranial ischemic complications in giant cell arteritis

Risk factors for visual loss in an Italian population‐based cohort of patients with giant cell arteritis

One Hundred Transient Monocular Central Retinal Artery Occlusions Secondary to Giant Cell Arteritis

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