Risk factors for early visual deterioration in temporal arteritis
- 1National Hospital for Neurology and Neurosurgery, London, UK
- 2University Department of Clinical Neurology, Institute of Neurology, London, UK
- 3Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH, USA
- 4Department of Clinical Neuroscience, Hammersmith Hospitals and Imperial College, London UK
- Dr Tobias Loddenkemper, Department of Neurology, S51, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA;
- Received 20 December 2006
- Revised 7 April 2007
- Accepted 12 April 2007
- Published Online First 15 May 2007
Background: Despite corticosteroid treatment, patients with temporal arteritis may continue to lose vision. However, predictors of progressive visual loss are not known.
Methods: We retrospectively reviewed 341 consecutive patients with suspected temporal arteritis who underwent temporal artery biopsy. 90 patients with biopsy proven temporal arteritis were included in our study.
Results: Twenty-one patients (23%) experienced continuous visual symptoms despite steroid therapy and 14 among these suffered persistent visual deterioration. Based on univariate analysis, visual loss on presentation was associated with disc swelling and a history of hypertension. Risk factors for progressive visual loss included older age, elevated C reactive protein and disc swelling.
Conclusion: Although corticosteroid therapy improves the visual prognosis in temporal arteritis, steroids may not stop the progression of visual loss. Our study reliably establishes the risk factors for visual loss in this serious condition. Whether addressing these risk factors early in their presentation can alter the visual outcome remains unknown. Individual risk anticipating treatment regimens and strategies might improve the visual prognosis in temporal arteritis in the future.
Competing interests: None.
- American College of Rheumatology
- C reactive protein
- temporal arteritis