gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Temporal arteriitis: known unknown

Meeting Abstract

  • corresponding author P. Kuthan - Ocní klinika VFN a 1. LF UK Praha, Praha, Czech Republic
  • P. Diblík - Ocní klinika VFN a 1. LF UK Praha, Praha, Czech Republic
  • P. Sklenka - Ocní klinika VFN a 1. LF UK Praha, Praha, Czech Republic
  • H. Cerná - Ocní klinika VFN a 1. LF UK Praha, Praha, Czech Republic

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.06.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog206.shtml

Published: September 22, 2004

© 2004 Kuthan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

The temporal arteriitis, also known as giant cell arteriitis or Morbus Horton, is potentially blinding disease of old people. Its diagnosis may cause different problems due to multiple clinical manifestations.

Methods

The authors present five short case reports to demonstrate the variability of the disease.

Results

The first patient visited her ophthalmologist because of diminished vision of her left eye. The erythrocytes sedimentation ratio (ESR) was 76mm/h. She was admitted to the hospital and after the corticoid therapy, the ESR lowered. The vision of the right eye remained normal, and of the left eye did not changed. The second patient was referred from a city hospital with very low vision of both eyes. The disease progressed so far that even after very aggressive corticoid therapy no improvement in visual functions was noticed. The third patient was referred to by her hematologist. Because the treatment started early, the vision was not deteriorated - the visual acuity remained normal and only one-sided altitudinal visual field defect without any worsening persisted. In the fourth patient, the subsequent combination of the arterial and non-arterial edemas of the optic nerve head has been demonstrated. The last patient, with originally erroneous suspicion of Lyme borreliosis, was primarily treated with antibiotics. After the switch to the steroid therapy, however, the originally high ESR lowered, and the visual acuity, as well as the visual field defects, improved in a very short time.

Conclusions

The temporal arteriitis is very treacherous disease. Its clinical manifestation is very variable; some symptoms are more common than others, but unfortunately, the universal model of the course of the disease cannot be established. The manifestations of the disease must be taken very carefully, as the decrease of visual functions in most cases never improves. The time works against the patient, and the doctor as well, and any delay of the onset of the corticoid therapy may have fatal consequences.