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Rheumatology Advance Access originally published online on February 20, 2009
Rheumatology 2009 48(5):537-541; doi:10.1093/rheumatology/kep011
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Involvement of the ophthalmic artery in giant cell arteritis visualized by 3T MRI

Julia Geiger1, Thomas Ness2, Markus Uhl1, Wolf A. Lagrèze2, Peter Vaith3, Mathias Langer1 and Thorsten A. Bley1,4

1Department of Radiology, 2Department of Ophthalmology, 3Department of Clinical Immunology and Rheumatology, University of Freiburg, Freiburg, Germany and 4Department of Radiology, University of Wisconsin–Madison, WI, USA.

Correspondence to: Julia Geiger, Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. E-mail: julia.geiger{at}uniklinik-freiburg.de


  Abstract

Objectives. To retrospectively analyse inflammatory involvement of the ophthalmic arteries in patients with GCA utilizing high-resolution MRI.

Methods. A cohort of 50 patients with GCA who had been examined by 1.5 or 3T high-field MRI was analysed retrospectively in a consensus reading for possible involvement of the ophthalmic arteries. In 43 patients, entire orbits were within the field of view. In all cases, the superficial cranial arteries displayed mural inflammation in post-contrast T1-weighted spin-echo (SE) images. MRI results were compared with ophthalmological findings, subjective visual symptoms and laboratory values, i.e. CRP and ESR.

Results. We observed mural contrast enhancement of the ophthalmic arteries in 20/43 patients (46%). Bilateral involvement was seen in 14, unilateral enhancement in six cases. Fifteen patients had ophthalmic vascular diseases: nine had anterior ischaemic optic neuropathy (AION), one posterior ischaemic optic neuropathy (PION), four revealed central retinal artery occlusion (CRAO) and one patient presented with narrowing of the retinal arteries. Funduscopy detected no arteritis-related changes in 22 cases. Of those patients who were MRI positive, seven had ophthalmological disease. Twenty-six patients complained of visual symptoms including amaurosis fugax, vision loss, diplopia or eye pain.

Conclusions. High-resolution MRI detects mural contrast enhancement consistent with inflammatory changes in the superficial cranial and extracranial arteries and additionally in the ophthalmic arteries. This provides insight in vasculitic orbital involvement during one single investigation.

KEY WORDS: MRI, Ophthalmic artery, Inflammation, GCA

Submitted 4 September 2008; revised version accepted 13 January 2009.
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