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Characteristics of patients with giant cell arteritis who experience visual symptoms

Shen Chean, Chung; Prior, James; Helliwell, Toby; Belcher, John; Mackie, Sarah L. ; Hider, Samantha; Liddle, Jennifer; Mallen, Christian

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Authors

Chung Shen Chean

Sarah L. Mackie

Jennifer Liddle



Abstract

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.

Citation

Shen Chean, C., Prior, J., Helliwell, T., Belcher, J., Mackie, S. L., Hider, S., …Mallen, C. (2019). Characteristics of patients with giant cell arteritis who experience visual symptoms. Rheumatology International, 39, 1789-1796. https://doi.org/10.1007/s00296-019-04422-5

Journal Article Type Article
Acceptance Date Aug 10, 2019
Online Publication Date Aug 22, 2019
Publication Date Oct 22, 2019
Publicly Available Date May 26, 2023
Journal Rheumatology International
Print ISSN 0172-8172
Electronic ISSN 1437-160X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 39
Pages 1789-1796
DOI https://doi.org/10.1007/s00296-019-04422-5
Keywords diagnostic delay, giant cell arteritis, visual symptoms
Publisher URL https://link.springer.com/article/10.1007%2Fs00296-019-04422-5#enumeration

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