Schmidt Dieter
Department of Ophthalmology, University of Freiburg, Germany.
Eur J Med Res. 2005 Jun 22;10(6):233-42.
To call attention to a malignant course of ocular ischemic syndrome in patients with giant cell arteritis (GCA). METHODS/PATIENT: A 84-year-old woman developed severe headache for about 3 (1/2) months prior to myocardial infarction and visual disturbances.
An anterior ischemic optic neuropathy (AION) in the right eye with a distinct reduction in visual acuity was found. The retina revealed several cotton-wool spots in both eyes. Serologic examinations showed inflammatory signs. Despite treatment with prednisolone, eye pressure decreased to 2 mm Hg in the right eye and 4 mm Hg in the left eye in a few days. An ischemic iritis developed in the right eye. Visual acuity worsened to detection of hand motions in the right eye and to 0.1 in the left eye. Approximately 8 (1/2) months after her initial headache, a biopsy was carried out. The patient was treated continuously with corticosteroids. Histology of the superficial temporal artery indicated inflammatory cells in the vessel wall. - The patients daughter developed symptoms of GCA at the age of 54 years.
An ocular ischemic syndrome points to a malignant course of the disease. A cardiac infarction can develop in GCA. A biopsy of the temporal artery can reveal inflammatory changes even after 8 (1/2) months.
提醒注意巨细胞动脉炎（GCA）患者眼部缺血综合征的恶性病程。方法/患者：一名84岁女性在心肌梗死和视力障碍出现前约3个半月出现严重头痛。
发现右眼有前部缺血性视神经病变（AION），视力明显下降。双眼视网膜可见多个棉絮斑。血清学检查显示有炎症迹象。尽管使用泼尼松龙治疗，但数天内右眼眼压降至2 mmHg，左眼眼压降至4 mmHg。右眼发生缺血性虹膜炎。右眼视力恶化至只能检测到手的动作，左眼视力降至0.1。在最初头痛约8个半月后进行了活检。患者持续接受皮质类固醇治疗。颞浅动脉组织学检查显示血管壁有炎症细胞。——患者的女儿在54岁时出现了GCA症状。
眼部缺血综合征提示疾病的恶性病程。GCA可发生心肌梗死。颞动脉活检即使在8个半月后仍可显示炎症变化。
