Background: The ophthalmic features of giant cell arteritis (GCA) involve a spectrum of severity from transient symptoms to bilateral visual loss from anterior ischaemic optic neuropathy or less commonly central retinal or cilioretinal artery occlusion. Reported ocular involvement varies between 10-70%. ^1,2 . At the Norfolk and Norwich University Hospital an interdisciplinary fast track service is provided for potential GCA patients. This report aims provides a complete picture of the frequency and nature of ocular involvement in GCA.

Objectives: 350 records of consecutive patients diagnosed objectively with GCA based on biopsy or imaging were reviewed. In our centre, the hospital pathway mandates all suspected GCA cases to have a formal ophthalmology assessment including visual acuity, pupil exam and full-dilated fundus assessment. Systemic and Ophthalmic symptoms and signs were recorded.

Methods: From January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1 . Only 6 patients with visual symptoms did not have any symptoms commonly associated with GCA.

Results: From January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1 . Only 6 patients with visual symptoms did not have any extra-ocular symptoms commonly associated with GCA.

Conclusion: We report the frequency of visual involvement in one of the largest cohorts of individuals with GCA. 29% have ocular symptoms. Partial or total field loss occurred in 13% of cases. 2% of patients presented with visual manifestations as the only feature of GCA. Rarely, permanent visual loss may occur without any other manifestation of GCA.

REFERENCES:

[1]Ivana Vodopivec, Joseph F Rizzo, III, Ophthalmic manifestations of giant cell arteritis, Rheumatology , Volume 57, Issue suppl_2, February 2018, Pages ii63–ii72.

[2]Saleh M, Turesson C, Englund M, Merkel PA, Mohammad AJ. Visual Complications in Patients with Biopsy-proven Giant Cell Arteritis: A Population-based Study. J Rheumatol . 2016;43(8):1559-1565.

Disclosure of Interests: None declared