Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis
A 66-year-old diabetic male presented to our center with a 3-day history of blurring of vision in the right eye, bilateral temporal headache, and diplopia. Fundus examination and optical coherence tomography revealed optic disc edema with optic atrophy of the left eye. The erythrocyte sedimentation...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Journal of Clinical Ophthalmology and Research |
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| Online Access: | https://journals.lww.com/10.4103/jcor.jcor_125_24 |
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| author | Richa Dhiman Kuntal Patel Nancy Sharma |
| author_facet | Richa Dhiman Kuntal Patel Nancy Sharma |
| author_sort | Richa Dhiman |
| collection | DOAJ |
| description | A 66-year-old diabetic male presented to our center with a 3-day history of blurring of vision in the right eye, bilateral temporal headache, and diplopia. Fundus examination and optical coherence tomography revealed optic disc edema with optic atrophy of the left eye. The erythrocyte sedimentation rate and C-reactive protein levels were elevated. Color Doppler ultrasonography of the temporal artery revealed left-sided temporal artery wall thickening, which was suggestive of temporal arteritis. The patient was diagnosed with the right eye arteritic anterior ischemic optic neuropathy (A-AION) and the left eye posterior ischemic optic neuropathy (PION), with multiple cranial nerve palsies secondary to giant cell arteritis (GCA). There was a marked improvement in vision from finger counting to 6/36, with a significant improvement in headache after administering high-dose steroids. This case exemplifies the atypical presentation of GCA with bilateral vision loss due to PION in one eye and AION in the other eye if not diagnosed early. |
| format | Article |
| id | doaj-art-6704205c948a4e738a9b3fa7a0e4a16d |
| institution | Kabale University |
| issn | 2320-3897 2320-3900 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Clinical Ophthalmology and Research |
| spelling | doaj-art-6704205c948a4e738a9b3fa7a0e4a16d2025-08-20T03:44:31ZengWolters Kluwer Medknow PublicationsJournal of Clinical Ophthalmology and Research2320-38972320-39002025-07-0113340740910.4103/jcor.jcor_125_24Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritisRicha DhimanKuntal PatelNancy SharmaA 66-year-old diabetic male presented to our center with a 3-day history of blurring of vision in the right eye, bilateral temporal headache, and diplopia. Fundus examination and optical coherence tomography revealed optic disc edema with optic atrophy of the left eye. The erythrocyte sedimentation rate and C-reactive protein levels were elevated. Color Doppler ultrasonography of the temporal artery revealed left-sided temporal artery wall thickening, which was suggestive of temporal arteritis. The patient was diagnosed with the right eye arteritic anterior ischemic optic neuropathy (A-AION) and the left eye posterior ischemic optic neuropathy (PION), with multiple cranial nerve palsies secondary to giant cell arteritis (GCA). There was a marked improvement in vision from finger counting to 6/36, with a significant improvement in headache after administering high-dose steroids. This case exemplifies the atypical presentation of GCA with bilateral vision loss due to PION in one eye and AION in the other eye if not diagnosed early.https://journals.lww.com/10.4103/jcor.jcor_125_24giant cell arteritisheadacheischemic optic neuropathymultiple cranial nerve involvement |
| spellingShingle | Richa Dhiman Kuntal Patel Nancy Sharma Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis Journal of Clinical Ophthalmology and Research giant cell arteritis headache ischemic optic neuropathy multiple cranial nerve involvement |
| title | Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| title_full | Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| title_fullStr | Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| title_full_unstemmed | Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| title_short | Bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| title_sort | bilateral ischemic optic neuropathy with multiple cranial nerve palsies in giant cell arteritis |
| topic | giant cell arteritis headache ischemic optic neuropathy multiple cranial nerve involvement |
| url | https://journals.lww.com/10.4103/jcor.jcor_125_24 |
| work_keys_str_mv | AT richadhiman bilateralischemicopticneuropathywithmultiplecranialnervepalsiesingiantcellarteritis AT kuntalpatel bilateralischemicopticneuropathywithmultiplecranialnervepalsiesingiantcellarteritis AT nancysharma bilateralischemicopticneuropathywithmultiplecranialnervepalsiesingiantcellarteritis |