Faaiq Hassan,Muhammed  Omar Qadir,Shirish  Dubey,Sergio   Pagliarini,Purnima  Mehta,
Challenges in the Diagnosis of Giant Cell Arteritis Before Visual Loss
Neurology and Neurobiology
2020
2613-7828
http://dx.doi.org/10.31487/j.NNB.2020.03.06
https://www.sciencerepository.org/challenges-in-the-diagnosis-of-giant-cell-arteritis-before-visual-loss_NNB-2020-3-106 
Abstract: Background: Giant cell arteritis (GCA) is the most common type of systemic vasculitis affecting the
elderly. Ophthalmic presentations of GCA in particular can be difficult to identify prior to permanent visual
loss occurring.
Methods: Here, we present 3 challenging cases as a retrospective series to highlight the variable
presentations of GCA with ophthalmic involvement, but GCA was not suspected due to atypical
presentation.
Results: Unfortunately, all 3 cases went on to develop visual loss in the affected eye due to a delay in
diagnosis or treatment. The authors wish to highlight the challenges posed to the referring clinicians, when
patients had systemic/ocular co-morbidities, which delayed the suspicion of GCA
Conclusion with a Practical Point: Our cases highlight the variable presentations of this condition as well
as the devastating ophthalmic implications that GCA can have. A high index of suspicion must be
maintained; particularly in elderly patients with atypical presentations.Keywords: Giant cell arteritis, temporal arteritis, ophthalmoplegia, vasculitis, inflammation