ArticleJournal of ophthalmology and advance research2026
Ocular Manifestations and Visual Outcomes of Patients with Giant Cell Arteritis.
Article in Journal of ophthalmology and advance research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Ocular involvement in giant cell arteritis (GCA) is common, yet there is limited literature addressing its specific ocular manifestations and their impact on visual outcomes. The objective was to evaluate the incidence of visual involvement, treatment, relapse rate, and visual outcome in patients with GCA. Methods: This is a single center retrospective cohort study. The study included 35 eyes from 37 consecutive patients with biopsy-proven GCA (TAB+), 39 eyes from 39 consecutive patients with clinically diagnosed GCA and negative biopsy (TAB-), and 16 eyes from 21 consecutive patients clinically diagnosed with GCA without undergoing a biopsy (no TAB). We collected demographic and clinical presentation. 26/37 (70%) in the TAB+ group, 29/39 (74%) in the TAB- group, and 14/21 (67%) in the no TAB group underwent at least one neuro-ophthalmic exam. Eyes were grouped into no, mild, or severe ocular involvement. At each visit, patients underwent neuro-ophthalmic evaluation, ophthalmic imaging, and visual fields. The main outcome measures were best-corrected visual acuity (BCVA), color perception (% correct), retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), area of foveal avascular zone (FAZ), and Humphrey visual field (HVF). Results: Within our entire cohort of 97 patients, 69 (71%) underwent neuro-ophthalmic examinations, 5 had unilateral involvement and 42 had bilateral involvement. At diagnosis, all patients were started on high dose prednisone, 9/37 (24%) intravenously and 28/37 (76%) orally. 16/37 (43%) patients were treated with adjuvant tocilizumab. Within our cohort, 5/97 (5%) patients had visual relapses, all within the first year after diagnosis. 15/50 (30%) eyes had no OI, 22/50 (44%) eyes had mild OI, and 13/50 (26%) eyes had severe OI. After 12 months of GCA diagnosis, patients with no OI compared to severe OI demonstrated: BCVA (logMAR 0.164 vs. 1.26, p<0.001), color perception (87% vs 6%, p<0.001), RNFL (93μm vs. 56μm, p<0.001), GCC (76μm vs. 52μm, p<0.001), FAZ (0.119 mm Conclusions: Visual involvement in GCA is common. The affected eyes had irreversible vision loss. GCC, RNFL, and FAZ were associated with poor visual outcome.
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