Ocular manifestations of giant cell arteritis

Introduction: Giant Cell Arteritis (GCA) is a vasculitis of the elderly that requires prompt diagnosis and treatment to preserve vision. As life expectancy increases in the United States and worldwide, the incidence of GCA is expected to rise. High dose steroids are often required to control the disease, but have risks, especially when used long term. Therefore, accurate and timely diagnosis, treatment, and monitoring of GCA may increase the likelihood of maintaining vision and quality of life. Areas covered: This review provides an overview of GCA with an emphasis on ophthalmologic manifestations. It summarizes the impact of new imaging advances in diagnosing GCA and the role imaging plays in relation to temporal artery biopsies. We discuss the latest treatment options and discuss the most recent clinical trials. Expert commentary: Although GCA is a systemic vasculitis, the symptoms may be highly variable and may be isolated to the eye. Understanding the various clinical presentations of the disease can lead to more rapid recognition and treatment. Although the temporal artery biopsy (TAB) remains the primary pathologic confirmation of the diagnosis of GCA, the diagnostic role of ultrasound and other imaging modalities of the temporal artery continues to improve and may eventually replace the TAB. Corticosteroids remain the mainstay of treatment for GCA, but exciting new treatment options are emerging (e.g. tocilizumab).