Cullen J F, Chan C M L, Chuah K L
Neuro-Ophthalmology Service, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751.
Singapore Med J. 2003 Jun;44(6):306-8.
Giant cell arteritis as the underlying cause of blindness in the elderly is common in the West but is not seen except on rare occasions in South East Asia. We describe an 86-year-old Chinese man from Singapore who presented with a central retinal artery occlusion. Biopsy of a prominent superficial temporal artery established the underlying cause to be giant cell arteritis which was also the eventual cause of death as the condition resulted in rupture of a dissecting aneurysm of the aorta. Giant cell arteritis should be considered in all cases of ischaemic eye disease in the elderly. The importance of early diagnosis lies in the very high incidence of second eye involvement within days or at most weeks in untreated patients. A high index of suspicion is required for diagnosis of this condition which is likely under-diagnosed in our local context.
巨细胞动脉炎作为老年人失明的潜在病因在西方很常见，但在东南亚除罕见情况外未见报道。我们描述了一名来自新加坡的86岁中国男性，他出现了视网膜中央动脉阻塞。对一条明显的颞浅动脉进行活检确定潜在病因是巨细胞动脉炎，这也是最终的死因，因为该疾病导致了主动脉夹层动脉瘤破裂。对于所有老年缺血性眼病病例都应考虑巨细胞动脉炎。早期诊断的重要性在于，未经治疗的患者在数天或最多数周内第二只眼受累的发生率非常高。诊断这种疾病需要高度的怀疑指数，在我们当地这种疾病可能未得到充分诊断。
