Giant Cell Arteritis: A Case Study and Review of Treatment

Authors

• Andrew Di Mattina OD, Department of Veterans AffairsFollow
• Jeffrey Sterling OD, Department of Veterans AffairsFollow
• Heather Whyte OD, Department of Veterans AffairsFollow

Medical Subject Headings

Giant Cell Arteritis; Vasculitis; Retinal Artery Occlusion; Anterior Ischemic Optic Neuropathy; Temporal Artery Biopsy; C-Reactive Protein; Erythrocyte Sedimentation Rate; Prednisone; Methylprednisolone; Tocilizumab; Methotrexate; Polymyalgia Rheumatica; Vision Disorders; Ultrasonography, Doppler

Abstract

Background: Giant cell arteritis (GCA) is the most common vasculitis affecting individuals over 50, and frequently leads to severe ischemic complications, most notably irreversible vision loss. Early diagnosis and prompt, aggressive treatment with corticosteroids is paramount to protect the fellow eye. The multifaceted clinical presentation of GCA, sometimes with atypical or sequential ocular involvement, can pose significant diagnostic challenges. This paper reviews current understanding of GCA pathophysiology, diagnosis, and current management strategies.

Case Report: A 70‑year‑old man presented with “cracked glass” vision in his right eye and was diagnosed with a branch retinal artery occlusion (BRAO). Two weeks later he developed sectoral vision loss in the left eye and was ultimately diagnosed with GCA. Treatment was initiated with IV steroids before being placed on 50 mg of oral prednisone daily, which was not tapered for four months. When he later presented to the Greenville VA significant steroid‑related side effects were found, including bone fragility and hyperglycemia. This case highlights the pathophysiology of GCA, the importance of recognizing its ocular risks, the diagnostic criteria and limitations of temporal artery biopsy, and current management strategies.

Conclusion: Giant cell arteritis is a potentially life and vision threatening condition. Prompt diagnosis and treatment are essential to positive outcomes. High dose corticosteroid therapy is required to induce remission and control the disease process. However, these drugs can have multiple side-effects, so a multi-disciplinary treatment strategy is recommended.

Recommended Citation

Di Mattina A, Sterling J, Whyte H. Giant Cell Arteritis: A Case Study and Review of Treatment. Optometric Clinical Practice. 2026; 8(2):39. https://doi.org/10.37685/uiwlibraries.2575-7717.8.2.1056

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Digital Object Identifier (DOI)

10.37685/uiwlibraries.2575-7717.8.2.1056