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2016 ; 123
(9
): 1999-2003
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gab.com Text
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English Wikipedia
Evaluating the Incidence of Arteritic Ischemic Optic Neuropathy and Other Causes
of Vision Loss from Giant Cell Arteritis
#MMPMID27297405
Chen JJ
; Leavitt JA
; Fang C
; Crowson CS
; Matteson EL
; Warrington KJ
Ophthalmology
2016[Sep]; 123
(9
): 1999-2003
PMID27297405
show ga
PURPOSE: To determine the incidence of permanent visual loss from giant cell
arteritis (GCA). DESIGN: Retrospective, population-based cohort. PARTICIPANTS:
All residents of Olmsted County, Minnesota, diagnosed with GCA between January 1,
1950, and December 31, 2009. METHODS: All cases of GCA were identified using the
Rochester Epidemiology Project (REP), which is a record-linkage system of medical
records for all patient-physician encounters among Olmsted County, Minnesota,
residents. The medical records were reviewed to identify and determine the cause
of permanent vision loss among patients with GCA. Systemic symptoms of GCA and
visual outcomes also were determined. MAIN OUTCOME MEASURES: Incidence and
outcomes of permanent vision loss from GCA. RESULTS: Among the 245 new cases of
GCA over the 60-year period, 20 patients (8.2%) had permanent vision loss due to
GCA. The frequency of arteritic ischemic optic neuropathy (A-ION) was 6.9% (95%
confidence interval [CI], 4.0-11.1) accounting for 85% of cases of permanent
vision loss. The frequency of central retinal artery occlusion (CRAO) was 1.6%
(95% CI, 0.4-4.2), and the frequency of cilioretinal artery occlusion was 0.4%
(95% CI, 0.01-2.3). The population-based age- and sex-adjusted annual incidence
of A-ION from GCA among persons aged ?50 years was 1.3 (95% CI, 0.7-2.0) per
100?000 population. Some 20% of patients with permanent vision loss from GCA had
vision loss without constitutional symptoms of GCA. Overall, there was no
significant difference between presenting and final visual acuities. CONCLUSIONS:
These population-based data provide the most accurate incidence of permanent
vision loss from GCA. This study confirms that visual outcomes from GCA-related
vision loss are poor and that 20% of patients with permanent visual loss from GCA
can present without systemic symptoms of GCA.