Giant cell arteritis and transient visual loss

doi:10.1136/bmj.b1809

Published 6 May 2009, doi:10.1136/bmj.b1809
Cite this as: BMJ 2009;338:b1809

Letters

Transient ischaemic attack

Giant cell arteritis and transient visual loss

The first 150 words of the full text of this article appear below.

Monocular transient visual loss due to emboli or ocular hypoperfusionusually occurs in isolation rather than accompanying a transientneurological deficit.¹ Adhiyaman and Adhiyaman did not mentionthat giant cell arteritis is an important cause of transientvisual loss in their 10 minute consultation on transient ischaemicattack.² Transient visual loss occurred in over 30% of patientswith giant cell arteritis and ophthalmic involvement in oneseries and is a strong predictor of permanent visual loss.³⁴ Delayed diagnosis and treatment of giant cell arteritis isassociated with bilateral blindness in patients with visualsymptoms.⁴

The authors also do not mention measuring inflammatory markersin the recommended investigation of transient ischaemic attack,²but we would advise checking erythrocyte sedimentation rate,C reactive protein, and platelet count in older patients withtransient monocular visual loss. High dose glucocorticoid treatment(prednisolone 1 mg/kg, maximum 60 mg, or pulsed methylprednisolone)should be started before . . . [Full text of this article]

Catherine M Guly, specialty registrar in medical ophthalmology¹, John A Olson, consultant ophthalmic physician¹

¹ Aberdeen Royal Infirmary, Aberdeen AB25 2ZN

catherine.guly@doctors.org.uk