Giant cell arteritis (GCA) is a vasculitis of large- and medium-sized arteries. It is the most common form of systemic vasculitis in the population over the age of 50 years. The incidence increases with age. There is a predilection for the aorta, branches of the ophthalmic artery, and extracranial branches of the carotid arteries. The diagnosis of GCA is urgent because of the possibility of permanent vision loss, most commonly secondary to ischemic optic neuropathy and central retinal artery occlusion. Delays in diagnosis and initiation of treatment usually lead to the ischemic complications. Systemic symptoms are common and protean. The diagnosis is based on suggestive symptoms, elevated inflammatory marker levels, and typically a temporal artery biopsy, the sensitivity of which is only about 75%. The classic histologic changes include arterial wall inflammation, fragmentation of the internal elastic lamina, and intimal thickening. Multinucleated giant cells, from which the name is derived, are seen in only one-half of positive temporal artery biopsies. GCA is considered an ophthalmologic emergency since treatment usually prevents fellow eye involvement. Corticosteroids remain the mainstay of therapy. The long durations of steroid therapy and attendant complications have prompted development of steroid-sparing agents like tocilizumab.
|Original language||English (US)|
|Title of host publication||Albert and Jakobiec's Principles and Practice of Ophthalmology|
|Subtitle of host publication||Fourth Edition|
|Publisher||Springer International Publishing|
|Number of pages||19|
|State||Published - Jan 1 2022|
All Science Journal Classification (ASJC) codes