Background Permanent visual loss, one of the most severe ischemic complications of giant cell arteritis (GCA), affects 6% of patients at our secondary/tertiary rheumatology center despite a fast track GCA diagnostic procedure.
Objectives To determine potential clinical and laboratory markers forecasting visual complications in GCA.
Methods We performed a paper chart review of GCA cases diagnosed between 01.09.2011 and 31.12.2014. Descriptive statistics was used to describe our cohort and appropriate post hoc tests to compare characteristics of patients with/without visual complications.
Results During the 40-month observation period, 83 new GCA cases (70% female) were identified. The median (interquartile range (IQR), range) symptom duration at presentation was 30 days (IQR 14-78 days, range 2-880). 28 patients (33.7%) reported of visual symptoms: blurred vision (16), diplopia (8), amaurosis fugax (5); permanent visual loss (5; all unilateral; in 1 patient after glucocorticoids), and ptosis (1). Conventional cardiovascular risk factors: obesity, arterial hypertension, hyperlipidemia, diabetes mellitus were not associated with visual complications in our cohort. Visual manifestations were significantly more common in patients with permanent atrial fibrillation (AF) (p=0.027). 80% of patients with AF were on anticoagulants. The mean erythrocyte sedimentation rate (69 vs 85 mm/h; p=0.007), C reactive protein (31 vs 93 mg/l, p=0.011) and platelet count (372 vs 405×109/l, p=0.001) were lower in patients with visual symptoms than in those without them. Antiphospholipid antibodies were not associated with visual symptoms.
Conclusions Visual complications were significantly more common in patients with AF which has so far not been reported. The presence of the conventional cardiovascular risk factors, antiphospholipid antibodies seem not to contribute to visual complications.
Disclosure of Interest None declared