Giant Cell Arteritis Presenting as Unilateral Anterior Ischemic Optic Neuropathy Associated with Bilateral Optic Nerve Sheath Enhancement on Magnetic Resonance Imaging

Research output: Contribution to journalArticle

Abstract

A 67-year-old man developed jaw claudication followed by loss of vision in the left eye caused by anterior ischemic optic neuropathy (AION). An erythrocyte sedimentation rate was normal, but C-reactive protein was slightly elevated. Although the patient had no evidence of a right optic neuropathy, magnetic resonance imaging (MRI) revealed bilateral optic nerve sheath enhancement. A temporal artery biopsy was consistent with active giant cell arteritis (GCA). Our case demonstrates that bilateral optic nerve sheath enhancement on MRI can be seen in the setting of unilateral AION. This unique combination of clinical and imaging findings has not been reported previously and extends the clinical spectrum of presentation of GCA.

Original languageEnglish (US)
Pages (from-to)360-363
Number of pages4
JournalJournal of Neuro-Ophthalmology
Volume35
Issue number4
DOIs
StatePublished - Dec 1 2015

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Ischemic Optic Neuropathy
Giant Cell Arteritis
Optic Nerve
Magnetic Resonance Imaging
Temporal Arteries
Optic Nerve Diseases
Blood Sedimentation
Jaw
C-Reactive Protein
Biopsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Ophthalmology

Cite this

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title = "Giant Cell Arteritis Presenting as Unilateral Anterior Ischemic Optic Neuropathy Associated with Bilateral Optic Nerve Sheath Enhancement on Magnetic Resonance Imaging",
abstract = "A 67-year-old man developed jaw claudication followed by loss of vision in the left eye caused by anterior ischemic optic neuropathy (AION). An erythrocyte sedimentation rate was normal, but C-reactive protein was slightly elevated. Although the patient had no evidence of a right optic neuropathy, magnetic resonance imaging (MRI) revealed bilateral optic nerve sheath enhancement. A temporal artery biopsy was consistent with active giant cell arteritis (GCA). Our case demonstrates that bilateral optic nerve sheath enhancement on MRI can be seen in the setting of unilateral AION. This unique combination of clinical and imaging findings has not been reported previously and extends the clinical spectrum of presentation of GCA.",
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AB - A 67-year-old man developed jaw claudication followed by loss of vision in the left eye caused by anterior ischemic optic neuropathy (AION). An erythrocyte sedimentation rate was normal, but C-reactive protein was slightly elevated. Although the patient had no evidence of a right optic neuropathy, magnetic resonance imaging (MRI) revealed bilateral optic nerve sheath enhancement. A temporal artery biopsy was consistent with active giant cell arteritis (GCA). Our case demonstrates that bilateral optic nerve sheath enhancement on MRI can be seen in the setting of unilateral AION. This unique combination of clinical and imaging findings has not been reported previously and extends the clinical spectrum of presentation of GCA.

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