Retrobulbar blood flow and visual organ function disturbance in the course of giant cell arteritis coexisting with optic disc drusen – a case report
Journal of Ultrasonography. 2012;12(49):337-343
Journal Title: Journal of Ultrasonography
ISSN: 2084-8404 (Print); 2451-070X (Online)
Publisher: Medical Communications Sp. z o.o.
Society/Institution: Polish Ultrasound Society
LCC Subject Category: Medicine: Medicine (General): Medical technology
Country of publisher: Poland
Language of fulltext: Polish, English
Full-text formats available: PDF, HTML
(Klinika Okulistyki, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Polska)
Michał Post (Klinika Okulistyki, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Polska)
Marcin Milchert (Klinika Reumatologii i Chorób Wewnętrznych, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Polska)
Abstract | Full Text
The review presented ophthalmologic syndrome connected with visual organ function disorder in giant cell arteritis patient concomitant with optic nerve disc drusen. Diagnostic difficulties were shown in relation to incidence of both similar ophthalmic symptoms as well as interpretation of specialists examinations results (pattern visual evoked potential test, scanning laser polarimetry, and perimetric tests – kinetic and static). Apart from ophthalmic investigations, significant role of radiological examinations was considered, especially color Doppler ultrasonography of retrobulbar circulation – optic artery, central retinal artery, long posterior ciliary arteries. Adequate interpretation of results seems to be crucial to establish scheme and timing of treatment in case of co-occurrence of the abovementioned disorders. In the presented case early implementation of steroid therapy resulted in improvement of blood flow parameters and the regression of ophthalmological complaints. Visual field deficiency in kinetic perimetry, reduced wave amplitude p100 in visual evoked potential test as well as decrease in number of optic nerve fibers in optic nerve disc region in scanning laser polarimetry exam can be diagnostic features in diagnosis of visual impairment in the course of giant cell arteritis and optic nerve disc drusen. Evaluation of blood flow velocity parameters in retrobulbar arteries in color Doppler ultrasonography is the most valuable screening in monitoring ophthalmic dysregulation in presented disorders.