Chean, CS, Prior, JA, Helliwell, T, Belcher, J, Mackie, SL, Hider, SL, Liddle, J and Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028 (2019) Characteristics of patients with giant cell arteritis who experience visual symptoms. Rheumatology International, 39 (10). pp. 1789-1796.

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Abstract

Permanent vision loss is one of the most serious complications of giant cell arteritis (GCA) and therefore prompt diagnosis is paramount. However, diagnosis of GCA remains challenging due to its frequently non-specific presentation. Our aim was to identify differences in the characteristics of GCA patients with, and without, current visual symptoms. A cross-sectional survey was mailed to patients with a GCA Read code entered in their GP electronic medical record. Responders were categorised as those currently reporting a visual symptom or not. We compared general and GCA-specific characteristics in these two groups. The association of diagnostic delay with subsequent experience of visual symptoms was examined using unadjusted and adjusted linear regression analysis. 318 GCA patients responded to the survey (59.6%). Responders were predominantly female (69.8%), with a mean age of 73.7 years (SD 8.2). 28% reported current visual symptoms. There was no statistically significant difference in the general characteristics between those with and without visual symptoms. Of GCA-specific characteristics, pre-GCA diagnosis of diplopia (p = 0.018), temporary (p ≤ 0.001) or permanent visual problems (p = 0.001) and hoarseness (p = 0.004) were more common among those reporting current visual symptoms. There was no association between the extent of diagnostic delay and reporting of current visual symptoms. Though we found few characteristics to distinguish between GCA patients with or without current visual symptoms, diagnostic delay was not associated with current visual symptoms. Our findings highlighted the continued difficulty for clinicians to identify GCA patients at the highest risk of visual complications.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Springer at https://doi.org/10.1007/s00296-019-04422-5 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: diagnostic delay, giant cell arteritis, visual symptoms
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 10 Sep 2019 08:13
Last Modified: 04 Oct 2019 09:29
URI: http://eprints.keele.ac.uk/id/eprint/6783

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