McKillop Elisabeth, Tejwani Deepak, Weir Cliff, Jay Jeffery
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
Can J Ophthalmol. 2006 Apr;41(2):201-3. doi: 10.1139/I06-009.
A 69-year-old male presented with bilateral blurred vision, left periocular pain, and headache. Ocular examination revealed a right optic neuropathy and left anterior segment ischaemia. An elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) raised suspicion of giant cell arteritis (GCA), which was confirmed by temporal artery biopsy. Treatment with intravenous methylprednisolone followed by a gradually reducing dose of oral prednisolone improved vision in both eyes.
GCA typically affects large- and medium-sized vessels. It is a recognised cause of anterior ischaemic optic neuropathy. Anterior segment ischaemia is usually caused by disease of the anterior ciliary arteries not typically affected by GCA. This case illustrates that GCA can rarely cause anterior segment ischaemia, without posterior segment involvement in the same eye.
一名69岁男性出现双侧视力模糊、左眼眼周疼痛和头痛。眼部检查发现右侧视神经病变和左侧眼前节缺血。红细胞沉降率（ESR）和C反应蛋白（CRP）升高，怀疑为巨细胞动脉炎（GCA），颞动脉活检证实了这一诊断。静脉注射甲泼尼龙治疗，随后逐渐减少口服泼尼松龙剂量，双眼视力均有改善。
GCA通常累及大中血管。它是前部缺血性视神经病变的公认病因。眼前节缺血通常由睫状前动脉疾病引起，而GCA通常不累及该动脉。该病例表明，GCA很少能引起眼前节缺血，而同一眼的后节未受累。
