1/33. Case presentations of retinal artery occlusions.BACKGROUND: Retinal artery occlusions typically result in sudden, unilateral painless loss of vision and may have varying presentations. They are associated with systemic diseases such as atherosclerosis, hypertension, and valvular heart disease. Additional risk factors include diabetes mellitus, cigarette smoking, giant-cell arteritis, and hyperlipidemia. They most often occur in persons 60 to 80 years of age. methods: Four patients have come to our clinics with varying degrees of visual loss as a result of retinal artery occlusions. The types of arteriolar occlusions presented include: precapillary arteriole occlusion, cilioretinal artery occlusion, branch retinal artery occlusion, and central retinal artery occlusion. RESULTS: patients were followed for their ocular involvement, but also included was medical management of the underlying systemic disease condition. Workup of retinal artery occlusion included laboratory testing, carotid duplex scans, and echocardiograms to uncover the possible systemic etiologies of the artery occlusion. CONCLUSION: Optometrists should recognize the signs and symptoms of the various arterial obstructions and refer patients for systemic treatment as indicated. patients who manifest retinal or pre-retinal artery occlusions should undergo thorough systemic evaluations for vascular disease, including: atherosclerotic disease, hypertension, and valvular heart disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/33. Assessment and management of polymyalgia rheumatica in older adults.polymyalgia rheumatica (PMR) is a periarticular rheumatic condition characterized by pain and stiffness, primarily in the neck, shoulders, hips, and pelvic girdle. Temporal arteritis (TA) or giant cell arteritis, the most common primary vasculitis in older adults, is found in approximately 10% to 30% of people who have PMR. Left untreated, TA can result in sudden, irreversible blindness. Geriatric nurses need to familiarize themselves with these disorders to accurately assess and manage people with them.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/33. Temporal arteritis presenting with scalp ulceration.We report the case of a 75-year-old-woman who presented with bilateral scalp ulcerations and blindness, accompanied by severe headache and scalp tenderness, due to bilateral temporal arteritis without systemic involvement. A biopsy taken from the border of an ulceration showed evidence of giant cell arteritis. She was treated with oral prednisone, 60 mg per day. The ulcerations healed in a few weeks but the vision loss was irreversible. This case highlights for temporal arteritis the importance of accurate and timely diagnosis as well as the need for prompt therapy with systemic steroids in order to avoid major complications, namely loss of vision. It also demonstrates that scalp necrosis and ulcerations are skin signs associated with a poor prognosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/33. Ischemic papilledema in giant-cell arteritis. Mucopolysaccharide deposition with normal intraocular pressure.A 68-year-old man died 18 days after the onset of ischemic optic neuropathy caused by histologically proven giant-cell arteritis. On histopathologic study of the eye, ischemic necrosis of the prelaminar and retrolaminar optic nerve was seen, along with the massive presence of acid mucopolysaccharides sensitive to testicular hyaluronidase. This finding was interpreted as an intrusion of vitreal material resulting from breaks in the internal limiting membrane and the pressure gradient from intraocular to extraocular tissues, an analogy to Schnabel degeneration in acute glaucoma.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/33. giant cell arteritis (temporal arteritis, cranial arteritis) and a case from singapore.giant cell arteritis as the underlying cause of blindness in the elderly is common in the West but is not seen except on rare occasions in South East asia. We describe an 86-year-old Chinese man from singapore who presented with a central retinal artery occlusion. biopsy of a prominent superficial temporal artery established the underlying cause to be giant cell arteritis which was also the eventual cause of death as the condition resulted in rupture of a dissecting aneurysm of the aorta. giant cell arteritis should be considered in all cases of ischaemic eye disease in the elderly. The importance of early diagnosis lies in the very high incidence of second eye involvement within days or at most weeks in untreated patients. A high index of suspicion is required for diagnosis of this condition which is likely under-diagnosed in our local context.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/33. Heeding clues to giant cell arteritis. Prompt response can prevent vision loss.To return to the case vignette, the new onset of headache in a 74-year-old woman with anemia and a markedly elevated ESR should alert the physician to the strong possibility of giant cell arteritis. Vision loss is the most significant potential early complication. Temporal artery biopsy is indicated, and treatment with corticosteroids should be started immediately. Close monitoring of the patient's symptoms and laboratory parameters is critical, as is surveillance for potential late complications.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/33. blindness and total ophthalmoplegia after aesthetic polymethylmethacrylate injection: case report.microspheres of polymethyl-methacrylate (PMMA) are exciting new soft-tissue fillers that are becoming increasing popular for facial rejuvenation. Some reports of side effects of this procedure are basically in respect to dermal reaction, with late-onset granulomatous lesion with giant cells and vacuoles. We report blindness and total ophthalmoplegia after PMMA injection into glabellar area in a healthy woman and review the literature.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/33. A case of biopsy-negative temporal arteritis--diagnostic challenges.A patient with systemic symptoms but no visual loss was investigated for suspected giant cell arteritis. Initial temporal artery biopsy was reported as negative; however, she returned with visual loss 2 months later, and the diagnosis of giant cell arteritis was confirmed with a subsequent biopsy. In hindsight, signs suggestive of the disease were present in the original biopsy, although the usual diagnostic features were absent.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
9/33. Visual loss due to central serous chorioretinopathy during corticosteroid treatment for giant cell arteritis.giant cell arteritis (GCA) can be a devastating disease resulting in blindness if not promptly diagnosed and treated. The only proven treatment for GCA is systemic corticosteroids; however, there are many side-effects associated with this therapy including ocular side-effects such as ocular hypertension, cataract formation and central serous chorioretinopathy. To raise physician awareness, a patient with biopsy-proven GCA is reported who lost vision during corticosteroid therapy because of central serous chorioretinopathy.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/33. Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis.This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate (ESR) and c-reactive protein (CRP). Both temporal artery biopsies were negative. neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
| | Next -> |