Impairment of central retinal artery hemodynamics in affected and fellow eyes in giant cell arteritis patients with unilateral vision loss
Copyright © 2023 Elsevier B.V. All rights reserved..
OBJECTIVES: Permanent visual impairment is a major complication of giant cell arteritis (GCA). We investigated the added value of color Doppler imaging (CDI) of the central retinal artery (CRA) in patients with suspected GCA for early risk evaluation before temporal artery biopsy (TAB) results become available.
METHODS: We conducted a non-interventional observational study of 30 consecutive patients hospitalized for suspected GCA, including a comprehensive analysis of clinical, laboratory, imaging, CDI and pathology data. GCA was diagnosed or excluded (GCA+, GCA-, respectively) according to American College of Rheumatology (ACR) criteria and TAB findings. Three patients not meeting ACR criteria were excluded secondarily. The GCA- group contained ten patients, and the GCA+ group contained 17 patients, including eight with unilateral, transient or permanent clinical visual impairment (CVI).
RESULTS: Mean blood flow velocity (mBFV) in the CRA was impaired in the affected eyes of GCA + CVI+ patients (1.9 ± 0.9 cm.s-1, p < 0.001) relative to controls (4.1 ± 1.0 cm.s-1), GCA- patients (3.6 ± 0.7 cm.s-1) and GCA + CVI- patients (3.8 ± 0.8 cm.s-1). The mBFVs of the CRA was similar for affected and fellow eyes (right or left). CRA mBFV measurements effectively differentiated between patients with and without CVI (ROC-curve analysis, AUC = 0.925 [95%CI: 0.700 to 0.996], p < 0.0001, 88% sensitivity, 89% specificity, and cutoff of ≤2.7 cm.s-1 for affected eyes; 75% sensitivity, 100% specificity and cutoff of ≤2.2 cm.s-1 for fellow eyes).
CONCLUSION: CDI facilities the early detection of visual ischemia risk in GCA+ patients, justifying urgent high-dose corticosteroid administration to save at least the fellow eye before pathology results become available.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
Autoimmunity reviews - 22(2023), 3 vom: 15. März, Seite 103272 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Boutigny, Alexandre [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 01.03.2023 Date Revised 01.03.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.autrev.2023.103272 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM351606939 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM351606939 | ||
| 003 | DE-627 | ||
| 005 | 20231226051804.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.autrev.2023.103272 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1171.xml |
| 035 | |a (DE-627)NLM351606939 | ||
| 035 | |a (NLM)36649878 | ||
| 035 | |a (PII)S1568-9972(23)00006-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Boutigny, Alexandre |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impairment of central retinal artery hemodynamics in affected and fellow eyes in giant cell arteritis patients with unilateral vision loss |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.03.2023 | ||
| 500 | |a Date Revised 01.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVES: Permanent visual impairment is a major complication of giant cell arteritis (GCA). We investigated the added value of color Doppler imaging (CDI) of the central retinal artery (CRA) in patients with suspected GCA for early risk evaluation before temporal artery biopsy (TAB) results become available | ||
| 520 | |a METHODS: We conducted a non-interventional observational study of 30 consecutive patients hospitalized for suspected GCA, including a comprehensive analysis of clinical, laboratory, imaging, CDI and pathology data. GCA was diagnosed or excluded (GCA+, GCA-, respectively) according to American College of Rheumatology (ACR) criteria and TAB findings. Three patients not meeting ACR criteria were excluded secondarily. The GCA- group contained ten patients, and the GCA+ group contained 17 patients, including eight with unilateral, transient or permanent clinical visual impairment (CVI) | ||
| 520 | |a RESULTS: Mean blood flow velocity (mBFV) in the CRA was impaired in the affected eyes of GCA + CVI+ patients (1.9 ± 0.9 cm.s-1, p < 0.001) relative to controls (4.1 ± 1.0 cm.s-1), GCA- patients (3.6 ± 0.7 cm.s-1) and GCA + CVI- patients (3.8 ± 0.8 cm.s-1). The mBFVs of the CRA was similar for affected and fellow eyes (right or left). CRA mBFV measurements effectively differentiated between patients with and without CVI (ROC-curve analysis, AUC = 0.925 [95%CI: 0.700 to 0.996], p < 0.0001, 88% sensitivity, 89% specificity, and cutoff of ≤2.7 cm.s-1 for affected eyes; 75% sensitivity, 100% specificity and cutoff of ≤2.2 cm.s-1 for fellow eyes) | ||
| 520 | |a CONCLUSION: CDI facilities the early detection of visual ischemia risk in GCA+ patients, justifying urgent high-dose corticosteroid administration to save at least the fellow eye before pathology results become available | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Arteritic anterior ischemic optic neuropathy | |
| 650 | 4 | |a Central retinal artery | |
| 650 | 4 | |a Central retinal artery occlusion | |
| 650 | 4 | |a Color Doppler imaging | |
| 650 | 4 | |a Diagnostic marker | |
| 650 | 4 | |a Giant cell arteritis | |
| 650 | 4 | |a Horton disease | |
| 650 | 4 | |a Vision loss | |
| 650 | 4 | |a Visual impairment | |
| 700 | 1 | |a Mohamedi, Nassim |e verfasserin |4 aut | |
| 700 | 1 | |a Pardo, Sarah Jeanne |e verfasserin |4 aut | |
| 700 | 1 | |a Bonnin, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Ketfi, Chahinez |e verfasserin |4 aut | |
| 700 | 1 | |a Ghaouti, Hichem |e verfasserin |4 aut | |
| 700 | 1 | |a Viana, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Frazier, Aline |e verfasserin |4 aut | |
| 700 | 1 | |a Roos, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Burlacu, Ruxandra |e verfasserin |4 aut | |
| 700 | 1 | |a Comarmond, Chloé |e verfasserin |4 aut | |
| 700 | 1 | |a Kubis, Nathalie |e verfasserin |4 aut | |
| 700 | 1 | |a Sène, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Bonnin, Philippe |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Autoimmunity reviews |d 2002 |g 22(2023), 3 vom: 15. März, Seite 103272 |w (DE-627)NLM126096996 |x 1873-0183 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2023 |g number:3 |g day:15 |g month:03 |g pages:103272 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.autrev.2023.103272 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2023 |e 3 |b 15 |c 03 |h 103272 | ||