ISSN 2757-8135 | E-ISSN 2757-9816
Giant cell arteritis presenting with isolated cotton wool spots: a case report [Eur Eye Res]
Eur Eye Res. 2023; 3(1): 36-40 | DOI: 10.14744/eer.2023.29494

Giant cell arteritis presenting with isolated cotton wool spots: a case report

Betul Akbulut Yagci1, Aylin Yaman2, Banu Lebe3, Meltem Soylev Bajin2, Ali Osman Saatci2
1Department of Ophthalmology, Aksaray University Education and Research Hospital, Aksaray, Türkiye
2Department of Ophthalmology, Dokuz Eylul University, Izmir, Türkiye
3Department of Pathology, Dokuz Eylul University, Izmir, Türkiye

This case aims to report a patient who presented with reduced vision in her left eye and was diagnosed with giant cell ar-teritis (GCA) associated with isolated cotton wool spots (CWS). An 82-year-old woman presented with reduced visual acuity of 20/200 in her left eye for a day. Fundus examination revealed only multiple peripapillary CWS in the left eye. She had an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). A preliminary diagnosis of temporal arteritis, intravenous high-dose steroid therapy, was administered for 3 days. Then, the systemic symptoms resolved, and her ESR and CRP dropped. Temporal artery biopsy confirmed the diagnosis of GCA. The next 2 months, in the fundus examination, CWS resolved completely. The patient continued using systemic steroids and subcutaneous methotrexate with long-term gradual reduction. This extreme case should raise awareness for clinicians in the etiological investigation of CWS to identify sight-threatening GCA and promptly initiate appropriate treatment.

Keywords: Cotton wool spot, giant cell arteritis; ophthalmological emergency.

Betul Akbulut Yagci, Aylin Yaman, Banu Lebe, Meltem Soylev Bajin, Ali Osman Saatci. Giant cell arteritis presenting with isolated cotton wool spots: a case report. Eur Eye Res. 2023; 3(1): 36-40

Corresponding Author: Betul Akbulut Yagci, Türkiye
Manuscript Language: English