COLOR DOPPLER IMAGING IN GIANT-CELL (TEMPORAL) ARTERITIS - SERIAL EXAMINATION AND COMPARISON WITH NONARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY

The ophthalmological manifestations of giant cell arteritis (GCA) pres ent a difficult diagnostic and management problem to the ophthalmologi st. The orbital circulation is frequently involved in the disease proc ess. The effects of GCA on orbital blood flow assessed by colour Doppl er imaging (CDI) were investigated in this study, Serial CDI examinati ons of the orbital blood vessels were performed (at presentation, 2 da ys, 1 week and at 1 month) on 7 patients with GCA, CDI examination at presentation was also performed on 4 patients with non-arteritic anter ior ischaemic optic neuropathy (AION) for comparison, Blood flow could not be detected in up to three arteries in the affected (ipsilateral) orbit of 6 GCA patients at presentation, Five of these patients were also found to have undetectable blood flow in the posterior ciliary ar teries of the contralateral orbit. Serial CDI examination revealed blo od flow alterations in arteritic patients despite treatment, Return of blood flow to normal was slow, and related to the clinical features, By contrast, only 1 of the patients with non-arteritic AION showed und etectable blood flow in a posterior ciliary artery, GCA leads to wides pread and prolonged alterations in orbital blood flow, CDI allows the detection and monitoring of such alterations in orbital blood flow, wh ich correlate with the clinical features of GCA, Serial CDI examinatio ns in GCA may be used to aid management decisions.