Which ophthalmic findings indicate retrobulbar involvement in giant cell arteritis (GCA) (temporal arteritis)?

Updated: Sep 03, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

With retrobulbar involvement (posterior ischemic optic neuropathy), optic pallor and atrophy gradually develop without antecedent papillitis. Central retinal artery occlusion causes pallor and diffuse retinal edema with a cherry-red spot because there are no ganglion cells at the foveal center (see the image below). Occlusion of the central retinal artery or its branches occurs in fewer than 10% of GCA cases with eye involvement. [73]   Nerve fiber layer infarcts may be a sign of retinal ischemia.

Central retinal artery occlusion (CRAO). Central retinal artery occlusion (CRAO).

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