Q: 74 years old male is admitted to ICU with a presumed diagnosis of Giant Cell Arteritis (GCA) with vision loss. Pulse steroid is started. Vision loss will probably be? (select one)
Vision loss in GCA is rarely reversible. Interestingly, patients report improvement in vision. Also, visual acuity tests confirm the improvement. Unfortunately, this is not a true recovery of retinal or optic nerve function. This subjective feeling is due to eccentric compensation for permanent visual deficits.
In any case, to salvage vision, patients should receive 3 days of 500 to 1000 mg of IV methylprednisolone followed by oral prednisone 1 mg/kg/day up to clinician discretion.
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