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Characteristics of patients with giant cell arteritis who experience visual symptoms

Lookup NU author(s): Dr Jenny Liddle

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2019, The Author(s). Permanent vision loss is one of the most serious complications of giant cell arteritis (GCA) and therefore prompt diagnosis is paramount. However, diagnosis of GCA remains challenging due to its frequently non-specific presentation. Our aim was to identify differences in the characteristics of GCA patients with, and without, current visual symptoms. A cross-sectional survey was mailed to patients with a GCA Read code entered in their GP electronic medical record. Responders were categorised as those currently reporting a visual symptom or not. We compared general and GCA-specific characteristics in these two groups. The association of diagnostic delay with subsequent experience of visual symptoms was examined using unadjusted and adjusted linear regression analysis. 318 GCA patients responded to the survey (59.6%). Responders were predominantly female (69.8%), with a mean age of 73.7 years (SD 8.2). 28% reported current visual symptoms. There was no statistically significant difference in the general characteristics between those with and without visual symptoms. Of GCA-specific characteristics, pre-GCA diagnosis of diplopia (p = 0.018), temporary (p ≤ 0.001) or permanent visual problems (p = 0.001) and hoarseness (p = 0.004) were more common among those reporting current visual symptoms. There was no association between the extent of diagnostic delay and reporting of current visual symptoms. Though we found few characteristics to distinguish between GCA patients with or without current visual symptoms, diagnostic delay was not associated with current visual symptoms. Our findings highlighted the continued difficulty for clinicians to identify GCA patients at the highest risk of visual complications.


Publication metadata

Author(s): Chean CS, Prior JA, Helliwell T, Belcher J, Mackie SL, Hider SL, Liddle J, Mallen CD

Publication type: Article

Publication status: Published

Journal: Rheumatology International

Year: 2019

Volume: 39

Issue: 10

Pages: 1789-1796

Print publication date: 01/10/2019

Online publication date: 22/08/2019

Acceptance date: 10/08/2019

Date deposited: 22/11/2019

ISSN (print): 0172-8172

ISSN (electronic): 1437-160X

Publisher: Springer Verlag

URL: https://doi.org/10.1007/s00296-019-04422-5

DOI: 10.1007/s00296-019-04422-5


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