Recovery of visual function in patients with biopsy-proven giant cell arteritis

Ophthalmology. 2003 Mar;110(3):539-42. doi: 10.1016/S0161-6420(02)01775-X.


Objective: To assess the visual function of patients with giant cell arteritis (GCA) who had visual loss from either anterior ischemic optic neuropathy (AION) or central retinal artery occlusion and had a subsequent improvement in visual acuity after treatment with corticosteroids.

Design: Retrospective, observational case series.

Participants: Thirty-two consecutive patients with biopsy-proven GCA treated at one institution between January 1992 and December 1997.

Intervention: Treatment with intravenous methylprednisolone 250 mg every 6 hours for 3 days, followed by oral prednisone 1 mg/kg daily for at least 4 weeks duration.

Main outcome measures: The number of patients with an improvement in visual acuity after treatment with intravenous methylprednisolone; neuro-ophthalmic evaluation, including visual acuity, funduscopy, and visual field examination of these patients.

Results: Improvement in visual acuity occurred in 5 of 39 eyes (13%) with visual loss from biopsy-proven GCA, and all 5 patients had AION. Despite the improvement of visual acuity in these 5 patients, perimetry revealed marked constriction of the visual field in each affected eye.

Conclusions: The prognosis for visual improvement in GCA is poor. Although an improvement in visual acuity occurred in 5 of our patients, marked constriction of the visual field was present in all of them.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Giant Cell Arteritis / complications
  • Giant Cell Arteritis / drug therapy
  • Giant Cell Arteritis / physiopathology*
  • Glucocorticoids / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Methylprednisolone / therapeutic use
  • Optic Neuropathy, Ischemic / complications
  • Prednisone / therapeutic use
  • Recovery of Function
  • Retinal Artery Occlusion / complications
  • Retrospective Studies
  • Vision Disorders / drug therapy
  • Vision Disorders / etiology
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology*
  • Visual Field Tests
  • Visual Fields


  • Glucocorticoids
  • Prednisone
  • Methylprednisolone