CLINICAL-FEATURES IN PATIENTS WITH PERMANENT VISUAL-LOSS DUE TO BIOPSY-PROVEN GIANT-CELL ARTERITIS

The objective was to determine associated clinical findings in patient s with visual loss due to giant cell arteritis (GCA) by means of a rec ord review of 146 patients with biopsy-proven GCA. Twenty-three (15.75 %) patients had lost vision. All of these patients complained of class ical GCA cranial symptoms for an average of 1.3 months, 34.8% had an a pparent isolated polymyalgia rheumatica for an average of 10.8 months and 65.2% had premonitory visual symptoms before visual loss for an av erage of 8.5 days. A clear delay in diagnosis and treatment was presen t in 15 patients (65.2%) who complained of at least two classical cran ial symptoms for longer than 3 weeks and/or who had presented premonit ory visual symptoms for longer than 72 h before blindness. Two additio nal patients lost vision while receiving standard steroid therapy. In conclusion, a high proportion of patients with permanent visual loss h ave a delayed diagnosis and treatment. A wider recognition of the dise ase would potentially reduce the prevalence of irreversible visual los s among GCA patients.