Polymyalgia rheumatica and giant cell arteritis

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7002.455a (Published 12 August 1995) Cite this as: BMJ 1995;311:455
  1. John Ferris,
  2. Robert Lamb
  1. Registrar in ophthalmology Consultant in ophthalmology West Suffolk Hospital, Bury St Edmunds IP33 2Qz

    High dose corticosteroids are recommended

    EDITOR,--We disagree with Gillian Pountain and Brian Hazleman's assertion that 20-40 mg of prednisolone is adequate initial treatment for patients with giant cell arteritis who have no ocular symptoms. As the authors state, appreciable visual loss occurs in 30-50% of patients with untreated giant cell arteritis. Anterior ischaemic optic neuropathy accounts for 90% of these cases, the remainder being secondary to retinal artery occlusions or, rarely, an ocular ischaemic syndrome. Although prodromal symptoms such as transient obscuration of vision …

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