Central retinal artery occlusion due to giant cell arteritis: A case report

Abstract

Introduction: Reports of giant cell arteritis cases in Thailand remain limited, despite its clinical significance.

Objective: To describe the symptoms, clinical manifestations, ophthalmologic assessments, laboratory investigations, and histopathological characteristics of patient with Central retinal artery occlusion due to giant cell arteritis

Case presentation: This case report presents an elderly Thai male patient who experienced a sudden onset of bilateral vision loss accompanied by a persistent headache. Three weeks later, the patient developed progressively worsening headache, generalized fatigue, and jaw claudication for three days before seeking medical attention. A comprehensive clinical evaluation was performed, including visual acuity assessment and detailed fundoscopic examination. Laboratory investigations revealed significantly elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. A temporal artery biopsy was subsequently conducted to confirm the diagnosis of giant cell arteritis (GCA). GCA is a systemic inflammatory disease affecting medium- to large-sized arteries, which can result in severe and irreversible vision loss. It is considered an ophthalmologic emergency that requires prompt recognition and urgent management. Early diagnosis and immediate initiation of corticosteroid therapy are critical in preventing permanent visual impairment and other complications.

Conclusion: The effective management of GCA necessitates a multidisciplinary approach, particularly involving collaboration between ophthalmologists and other medical specialists.