In patients over 50 presenting with central retinal artery occlusion, giant cell arteritis must be actively considered — the clinical stakes extend well beyond the affected eye.
This protocol addresses patients over 50 years of age with central retinal artery occlusion in whom giant cell arteritis (GCA) is strongly suspected or has been diagnosed. In this age group, GCA should be actively considered as a causative factor. Recognition and prompt action are critical: the contralateral eye and systemic vasculature are at risk, and delay can result in irreversible harm.
Management centres on urgent systemic corticosteroid therapy, initiated empirically, alongside an arranged diagnostic evaluation. The structured protocol specifies the complete sequence, including timing and associated workup steps.
DOI: 10.1016/j.ophtha.2024.12.024
In patients over 50 years of age, giant cell arteritis (GCA) should be suspected.
When GCA is strongly suspected or diagnosed, urgent systemic corticosteroid therapy should be considered in order to preserve vision in the contralateral eye as well as prevent systemic morbidity and mortality.
In cases of GCA, prompt initiation of systemic corticosteroid therapy is critical to prevent vision loss in the fellow eye or vascular occlusion elsewhere.
In addition, corticosteroids should be initiated empirically and a temporal artery biopsy scheduled in patients with high clinical suspicion for GCA.
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