NR 3-4/2003
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Neuropatia nerwu wzrokowego w przebiegu
olbrzymiokomórkowego zapalenia tętnic
Optic neuropathy in giant cell arteritis
Aldona Wilk, Krystyna Kazimierczuk
Z Kliniki Okulistycznej Wojskowego Instytutu Medycznego w Warszawie
Kierownik: prof. dr hab. n. med. Andrzej Stankiewicz |
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| Summary: |
Anterior ischemic optic neuropathy (AION) is the result of
infarct of the optic nerve head, caused by occlusion of one or more short posterior
ciliary arteries. On the base of different treatment and prognosis there are two forms of
AION: arteritic and non-arteritic (NAION). Arteritic ischemic optic neuropathy is caused
by giant cell arteritis (GCA). The most typical symptoms are: the sudden and deep vision
loss and headache, scalp tenderness, jaw claudication, muscle ache, fever and weight loss.
The ophthalmologist usually finds an abnormal pupil, a swollen optic nerve (disc edema),
and peripheral or central vision loss (or both). About 70% of cases are not progressive,
i.e., the vision remains stable, but reduced. The ESR is usually markedly elevated.
Temporal artery biopsy is useful in confirming the diagnosis of arteritic AION. Treatment
involves the immediate administration of systemic steroids. Though steroid therapy rarely
results in the return of vision, it is beneficial in protecting the fellow eye from vision
loss and improving long-term systemic health. |
| Słowa kluczowe: |
przednia niedokrwienna neuropatia, olbrzymiokomórkowe
zapalenie tętnic, ubytki pola widzenia, tętnice rzęskowe tylne krótkie. |
| Key words: |
anterior ischemic optic neuropathy, giant cell arteritis,
visual field defects, short posterior ciliary arteries. |
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