AN ATYPICAL PRESENTATION OF ARTERITIC ISCHEMIC OPTIC NEUROPATHY

Mark Shust

Abstract

An elderly woman presented with sudden, painless, unilateral loss of vision with an afferent pupillary defect and disc edema. Due to the patient's age, efforts were made to rule out temporal arteritis as a cause of the vision loss. A thorough history failed to reveal scalp pain or tenderness, headache, jaw claudication, or any other systemic symptoms traditionally associated with temporal arteritis. An immediate erythrocyte sedimentation rate, which is elevated in 90% of patients with temporal arteritis, was performed and yielded results well within normal limits. Despite these findings, a diagnosis of arteritic ischemic optic neuropathy was made based on a subsequent temporal artery biopsy which was positive for temporal arteritis. Aggressive steroid therapy was initiated to prevent involvement in the other eye. This case demonstrates that the systemic symptoms and elevated erythrocyte sedimentation rate commonly associated with temporal arteritis. Aggressive steroid therapy was initiated to prevent involvement in the other eye. This case demonstrates that the systemic symptoms and elevated erythrocyte sedimentation rate commonly associated with temporal arteritis may be unreliable tools in diagnosing the condition.

Details

Year: 1992

Program Number: Poster 46

Author Affiliation: n/a

Co-Authors: Helene Kaiser

Co-Author Affiliation: n/a

Room: Great Hall