The island of ischaemia: submacular choroidal nonperfusion in giant cell arteritis

Gandhi, Jagdeep Singh

doi:10.1038/eye.2011.305

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Nemiroff et al [24] noted that swept source OCT-A did provide a simple noninvasive tool to evaluate choroidal ischemia in 3 cases with GCA. While choroidal ischemia is often asymptomatic, ensuing visual loss have been reported when involving the macula or the papillomacular bundle [25][26][27][28][29]. Despite the fact that choroidal ischemia is described as being rare in the present literature [18,[25][26][27][28][29], it is probable that this irregularity of the choroidal circulation is frequently overlooked.…”

Section: Discussionmentioning

confidence: 70%

“…While choroidal ischemia is often asymptomatic, ensuing visual loss have been reported when involving the macula or the papillomacular bundle [25][26][27][28][29]. Despite the fact that choroidal ischemia is described as being rare in the present literature [18,[25][26][27][28][29], it is probable that this irregularity of the choroidal circulation is frequently overlooked. The current research and other communications [30,31] confirm that choroidal ischemia is frequently seen.…”

Section: Discussionmentioning

confidence: 70%

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Choroidal ischemia as one cardinal sign in giant cell arteritis

Casella

Mansour

et al. 2022

Int J Retin Vitr

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Purpose To describe chorioretinal signs in a case series of Giant Cell Arteritis (GCA). Methods This is a multicenter retrospective observational case series with GCA that presented with a headache and an abrupt, unilateral loss in vision. Workup included temporal artery biopsies, intravenous fluorescein angiography, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), blood levels of erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results There are a total of 8 GCA instances presented. Average age was 74.5. (Range 68–83 years). The patients reported that one eye's visual loss had suddenly started, along with a fresh headache and other systemic symptoms. Eight patients exhibited choroidal ischemia, five paracentral acute middle maculopathy (PAMM) lesions, five cotton wool spots, four anterior ischemic optic neuropathy, and one central retinal arterial occlusion at the time of presentation. The average ESR at presentation was 68 mm/hr (range 4–110), and 4/6 individuals had a significant increase. The mean CRP level was 6.2 mg/dL (range 2.0–15.4), and the level was always over the normal range. All patients' temporal artery biopsies were positive. Conclusion Alongside PAMM lesions, cotton wool spots, anterior ischemic optic neuropathy, and central retinal artery occlusion, choroidal ischemia is a key angiographic indicator in the diagnosis of GCA. It may be crucial to recognize these typical ischemic chorioretinal signs while diagnosing GCA.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 70%

Choroidal ischemia as one cardinal sign in giant cell arteritis

Casella

Mansour

et al. 2022

Int J Retin Vitr

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“…Gandhi confirmed that GCA can cause localized ischemic patches in the choroid while sparing the optic nerve and retinal arteries and recommended to consider the disease in inexplicable visual loss of older patients [45]. More recently, Ness et al reported a 64-year-old man who was referred with bilateral painless visual loss in whom they noticed placoid maculopathy related to choroidal hypoperfusion.…”

Section: Large Vessel Vasculitis (Lvv)mentioning

confidence: 98%

Choroidal involvement in systemic vasculitis: a systematic review

Özdal

Tuğal-Tutkun

2022

J Ophthal Inflamm Infect

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Systemic vasculitides are a large group of heterogeneous diseases characterized by inflammatory destruction of blood vessels targeting diverse organs and tissues including the eye. As the most vascularized layer of the eye, the choroid is expected to be affected in multiple systemic rheumatologic diseases with vascular involvement. While there are plenty of studies investigating retinal vascular involvement, choroidal vascular involvement in systemic vasculitides has not been investigated in isolation. However, choroidal manifestations including thickness changes, choroidal vasculitis and ischemia may be the earliest diagnostic features of systemic vasculitic diseases. Thus, multimodal imaging of the choroid may help early detection of choroidal involvement which may also have prognostic implications in these life-threatening diseases. This article aimed to review involvement of the choroid in systemic vasculitic diseases.

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“…In 1 case, fluorescein angiography revealed focal perfusion defects in the submacular choroid, with sparing of the optic nerve and retinal arteries. 103 A recent retrospective review of 22 Mexican patients with GCA reported a mean (SD) age of 73 (7.9) years. The most frequent presenting symptoms included headache (90%), constitutional symptoms (86%), and polymyalgia rheumatica (59%).…”

Section: Giant Cell Arteritismentioning

confidence: 99%