BackgroundGiant cell arteritis (GCA) is a systemic vasculitis of medium and large-size vessels and can led to permanent visual loss in elderly patients. GCA is very rare among Asians. We report a Chinese patient presenting with acute bilateral anterior ischemic optic neuropathy, and the temporal artery biopsy proved the diagnose of GCA.Case presentationA 77-year-old Chinese man presented with sudden bilateral blindness for 5days with a severe headache. Funduscopic examination revealed bilateral optic disc swollen with chalky white pallid appearance. The blood tests showed the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevated dramatically. The color duplex ultrasonography (CDUS) of the superficial temporal artery revealed the inflammation of the vessel wall as a halo sign. The temporal artery biopsy was perfumed and the pathology revealed luminal occlusion with multinuclear giant cell infiltration. The patient was treated with intravenous methylprednisolone for 3days and oral prednisone weaning for 12months. The visual acuity remained no light perception at one year follow-up.ConclusionsAlthough very rare in Asian, GCA can led to permanent blindness in elderly Chinese caused by anterior ischemic optic neuropathy. The noninvasive CDUS might be a promising technique for diagnose GCA in highly suspected patients.
[1]Fudan Univ, Eye Ear Nose & Throat Hosp, Dept Ophthalmol, Shanghai 200031, Peoples R China;
[2]Shanghai Deji Hosp, Dept Neurol, Shanghai 200010, Peoples R China;
[3]Fudan Univ, Huashan Hosp, Dept Neurol, Shanghai 200040, Peoples R China;
[4]Fudan Univ, Huashan Hosp, Dept Rheumatol, Shanghai 200040, Peoples R China;
[5]Fudan Univ, NHC Key Lab Myopia, 83 Fenyang Rd, Shanghai 200031, Peoples R China
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