Giant cell arteritis is best prevented from causing blindness by which approach?

Giant cell arteritis is best prevented from causing blindness by which approach?

• A. Prompt recognition and initiation of high-dose corticosteroids
• B. Low-dose aspirin alone
• C. Antibiotics
• D. Surgical debulking

Answer: (A)

Giant cell arteritis can cause irreversible vision loss from ischemia of the optic nerve, so the best way to prevent blindness is to recognize it promptly and start high-dose corticosteroids right away, even before biopsy confirmation. Steroids rapidly suppress the arterial inflammation, reduce edema, and improve blood flow to the optic nerve, lowering the risk of ischemic optic neuropathy. If vision is threatened or symptoms are strong suspects, use a regimen such as high-dose IV methylprednisolone (1 g daily for a few days) or, if vision is not acutely compromised, high-dose oral prednisone (about 40–60 mg daily) with a slow taper over months. Low-dose aspirin alone does not prevent vision loss in GCA, antibiotics are not indicated, and surgical debulking has no role.

Giant cell arteritis can cause irreversible vision loss from ischemia of the optic nerve, so the best way to prevent blindness is to recognize it promptly and start high-dose corticosteroids right away, even before biopsy confirmation. Steroids rapidly suppress the arterial inflammation, reduce edema, and improve blood flow to the optic nerve, lowering the risk of ischemic optic neuropathy. If vision is threatened or symptoms are strong suspects, use a regimen such as high-dose IV methylprednisolone (1 g daily for a few days) or, if vision is not acutely compromised, high-dose oral prednisone (about 40–60 mg daily) with a slow taper over months. Low-dose aspirin alone does not prevent vision loss in GCA, antibiotics are not indicated, and surgical debulking has no role.