{"id":"https://openalex.org/W7225189267","doi":"https://doi.org/10.1093/rap/rkag113.068","title":"P038 Sequential bilateral central retinal artery occlusion despite high-dose glucocorticoid therapy in biopsy-proven giant cell arteritis","display_name":"P038 Sequential bilateral central retinal artery occlusion despite high-dose glucocorticoid therapy in biopsy-proven giant cell arteritis","publication_year":2026,"publication_date":"2026-11-01","ids":{"openalex":"https://openalex.org/W7225189267","doi":"https://doi.org/10.1093/rap/rkag113.068"},"language":"en","primary_location":{"id":"doi:10.1093/rap/rkag113.068","doi":"https://doi.org/10.1093/rap/rkag113.068","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.068","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1093/rap/rkag113.068","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5112989548","display_name":"Hiba Salih","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210127968","display_name":"Basildon Hospital","ror":"https://ror.org/02de7mm40","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I263303288","https://openalex.org/I4210127968"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Hiba Salih","raw_affiliation_strings":["Rheumatology, Basildon University Hospital , Basildon,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Rheumatology, Basildon University Hospital , Basildon,","institution_ids":["https://openalex.org/I4210127968"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019452960","display_name":"Anupama C. Nandagudi","orcid":"https://orcid.org/0000-0003-2035-8395","observed_orcids":["https://orcid.org/0000-0003-2035-8395"]},"institutions":[{"id":"https://openalex.org/I4210127968","display_name":"Basildon Hospital","ror":"https://ror.org/02de7mm40","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I263303288","https://openalex.org/I4210127968"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Anupama Nandagudi","raw_affiliation_strings":["Rheumatology, Basildon University Hospital , Basildon,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Rheumatology, Basildon University Hospital , Basildon,","institution_ids":["https://openalex.org/I4210127968"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I4210127968"],"apc_list":{"value":2255,"currency":"GBP","value_usd":2974},"apc_paid":{"value":2255,"currency":"GBP","value_usd":2974},"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"10","issue":"Supplement_1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11194","display_name":"Ocular Diseases and Beh\u00e7et\u2019s Syndrome","score":0.003000000026077032,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12599","display_name":"Retinal and Optic Conditions","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/giant-cell-arteritis","display_name":"giant cell arteritis","score":0.9980000257492065},{"id":"https://openalex.org/keywords/central-retinal-artery-occlusion","display_name":"central retinal artery occlusion","score":0.9750000238418579},{"id":"https://openalex.org/keywords/glucocorticoid-therapy","display_name":"glucocorticoid therapy","score":0.7960000038146973},{"id":"https://openalex.org/keywords/temporal-artery-biopsy","display_name":"temporal artery biopsy","score":0.609000027179718},{"id":"https://openalex.org/keywords/temporal-artery-ultrasound","display_name":"temporal artery ultrasound","score":0.8479999899864197},{"id":"https://openalex.org/keywords/halo-sign","display_name":"halo sign","score":0.7080000042915344},{"id":"https://openalex.org/keywords/methotrexate","display_name":"methotrexate","score":0.7329999804496765},{"id":"https://openalex.org/keywords/steroid-sparing-therapy","display_name":"steroid-sparing therapy","score":0.8379999995231628},{"id":"https://openalex.org/keywords/carotid-stenosis","display_name":"carotid artery stenosis","score":0.7059999704360962},{"id":"https://openalex.org/keywords/clopidogrel","display_name":"clopidogrel","score":0.7509999871253967},{"id":"https://openalex.org/keywords/antiplatelet-therapy","display_name":"antiplatelet therapy","score":0.6209999918937683},{"id":"https://openalex.org/keywords/inflammatory-markers","display_name":"inflammatory markers","score":0.4339999854564667},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.4449999928474426}],"concepts":[{"id":"https://openalex.org/C2776712624","wikidata":"https://www.wikidata.org/wiki/Q707816","display_name":"Giant cell arteritis","level":4,"score":0.9404000043869019},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9369000196456909},{"id":"https://openalex.org/C2776449918","wikidata":"https://www.wikidata.org/wiki/Q3348620","display_name":"Central retinal artery occlusion","level":3,"score":0.7519999742507935},{"id":"https://openalex.org/C2776715498","wikidata":"https://www.wikidata.org/wiki/Q11426176","display_name":"Prednisolone","level":2,"score":0.6565999984741211},{"id":"https://openalex.org/C2780841215","wikidata":"https://www.wikidata.org/wiki/Q422549","display_name":"Glucocorticoid","level":2,"score":0.6388999819755554},{"id":"https://openalex.org/C2780372218","wikidata":"https://www.wikidata.org/wiki/Q417222","display_name":"Methylprednisolone","level":2,"score":0.6341999769210815},{"id":"https://openalex.org/C2775926640","wikidata":"https://www.wikidata.org/wiki/Q489722","display_name":"Central retinal artery","level":3,"score":0.5848000049591064},{"id":"https://openalex.org/C2781343717","wikidata":"https://www.wikidata.org/wiki/Q1751810","display_name":"Arteritis","level":2,"score":0.5253000259399414},{"id":"https://openalex.org/C2776015282","wikidata":"https://www.wikidata.org/wiki/Q644318","display_name":"Vasculitis","level":3,"score":0.48420000076293945},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.45980000495910645},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4226999878883362},{"id":"https://openalex.org/C2780837183","wikidata":"https://www.wikidata.org/wiki/Q186029","display_name":"Optic nerve","level":2,"score":0.3824000060558319},{"id":"https://openalex.org/C2778333808","wikidata":"https://www.wikidata.org/wiki/Q515848","display_name":"Internal carotid artery","level":2,"score":0.3822000026702881},{"id":"https://openalex.org/C2777628954","wikidata":"https://www.wikidata.org/wiki/Q18216","display_name":"Aspirin","level":2,"score":0.3749000132083893},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3693999946117401},{"id":"https://openalex.org/C2777798775","wikidata":"https://www.wikidata.org/wiki/Q207550","display_name":"Infarction","level":3,"score":0.3625999987125397},{"id":"https://openalex.org/C2778040396","wikidata":"https://www.wikidata.org/wiki/Q494694","display_name":"Superficial temporal artery","level":4,"score":0.3573000133037567},{"id":"https://openalex.org/C2780827179","wikidata":"https://www.wikidata.org/wiki/Q422001","display_name":"Retinal","level":2,"score":0.35670000314712524},{"id":"https://openalex.org/C2909556870","wikidata":"https://www.wikidata.org/wiki/Q2444886","display_name":"Retinal Artery Occlusion","level":3,"score":0.3402000069618225},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.31139999628067017},{"id":"https://openalex.org/C2910707947","wikidata":"https://www.wikidata.org/wiki/Q489722","display_name":"Retinal Artery","level":3,"score":0.3061000108718872},{"id":"https://openalex.org/C118487528","wikidata":"https://www.wikidata.org/wiki/Q161437","display_name":"Ophthalmology","level":1,"score":0.30239999294281006},{"id":"https://openalex.org/C2778328719","wikidata":"https://www.wikidata.org/wiki/Q7316771","display_name":"Retinal vasculitis","level":4,"score":0.29989999532699585},{"id":"https://openalex.org/C2780662894","wikidata":"https://www.wikidata.org/wiki/Q497574","display_name":"Ophthalmic artery","level":3,"score":0.2921000123023987},{"id":"https://openalex.org/C2778212899","wikidata":"https://www.wikidata.org/wiki/Q907325","display_name":"Magnetic resonance angiography","level":3,"score":0.2892000079154968},{"id":"https://openalex.org/C2780079024","wikidata":"https://www.wikidata.org/wiki/Q1752891","display_name":"Polymyalgia rheumatica","level":5,"score":0.28859999775886536},{"id":"https://openalex.org/C2776268601","wikidata":"https://www.wikidata.org/wiki/Q968808","display_name":"Occlusion","level":2,"score":0.2815999984741211},{"id":"https://openalex.org/C2779433908","wikidata":"https://www.wikidata.org/wiki/Q2146228","display_name":"Amaurosis fugax","level":3,"score":0.28040000796318054},{"id":"https://openalex.org/C2778257484","wikidata":"https://www.wikidata.org/wiki/Q555066","display_name":"Visual acuity","level":2,"score":0.27889999747276306},{"id":"https://openalex.org/C2775841333","wikidata":"https://www.wikidata.org/wiki/Q498179","display_name":"Middle cerebral artery","level":3,"score":0.27459999918937683},{"id":"https://openalex.org/C2777748206","wikidata":"https://www.wikidata.org/wiki/Q285787","display_name":"Amaurosis","level":2,"score":0.271699994802475},{"id":"https://openalex.org/C2776820930","wikidata":"https://www.wikidata.org/wiki/Q9655","display_name":"Artery","level":2,"score":0.26829999685287476},{"id":"https://openalex.org/C2781064879","wikidata":"https://www.wikidata.org/wiki/Q214275","display_name":"Common carotid artery","level":3,"score":0.26829999685287476},{"id":"https://openalex.org/C2776763380","wikidata":"https://www.wikidata.org/wiki/Q362719","display_name":"Anterior ischemic optic neuropathy","level":3,"score":0.2678999900817871},{"id":"https://openalex.org/C541997718","wikidata":"https://www.wikidata.org/wiki/Q188151","display_name":"Ischemia","level":2,"score":0.2646999955177307},{"id":"https://openalex.org/C2776184368","wikidata":"https://www.wikidata.org/wiki/Q1576205","display_name":"Carotid artery disease","level":4,"score":0.25859999656677246},{"id":"https://openalex.org/C2780645631","wikidata":"https://www.wikidata.org/wiki/Q671554","display_name":"Stroke (engine)","level":2,"score":0.2574000060558319},{"id":"https://openalex.org/C2778674544","wikidata":"https://www.wikidata.org/wiki/Q1414805","display_name":"Systemic disease","level":3,"score":0.25699999928474426},{"id":"https://openalex.org/C143409427","wikidata":"https://www.wikidata.org/wiki/Q161238","display_name":"Magnetic resonance imaging","level":2,"score":0.2565999925136566},{"id":"https://openalex.org/C2777374719","wikidata":"https://www.wikidata.org/wiki/Q7663822","display_name":"Systemic vasculitis","level":4,"score":0.2556000053882599}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/rap/rkag113.068","doi":"https://doi.org/10.1093/rap/rkag113.068","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.068","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13728564","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728564/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728564/pdf/rkag113.068.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatol Adv Pract","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/rap/rkag113.068","doi":"https://doi.org/10.1093/rap/rkag113.068","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.068","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225189267.pdf","grobid_xml":"https://content.openalex.org/works/W7225189267.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2922190804","https://openalex.org/W7225168798","https://openalex.org/W2887144430","https://openalex.org/W4391105949","https://openalex.org/W4322582547","https://openalex.org/W2892347150","https://openalex.org/W2395154456","https://openalex.org/W2322901940","https://openalex.org/W7164150795","https://openalex.org/W7214964856"],"abstract_inverted_index":{"Abstract":[0],"Introduction":[1],"Giant":[2],"cell":[3,183,712],"arteritis":[4,713],"(GCA)":[5],"is":[6,413],"the":[7,22,45,111,164,188,231,372,406,460,508,563,566,578,596,620,629,658,668,707,718,759],"most":[8,407],"common":[9],"systemic":[10,505,722],"vasculitis":[11,283],"affecting":[12,163],"older":[13],"adults":[14],"and":[15,66,93,116,131,156,174,190,209,266,281,294,308,356,384,396,412,428,492,503,554,586,610,643,650,666,714,766,774,804,809,826,834],"represents":[16],"a":[17,64,153,223,268,325,812],"medical":[18],"emergency":[19],"because":[20],"of":[21,24,47,57,69,160,187,227,238,301,318,371,398,405,410,426,456,462,511,580,598,628,660,672,710,720,732,758],"risk":[23,461],"irreversible":[25,519],"visual":[26,36,49,108,161,228,261,387,394,419,471,501,751],"loss.":[27],"High-dose":[28],"glucocorticoids":[29,458,734],"usually":[30],"prevent":[31],"further":[32,224,386,463,593],"ischaemic":[33,433,445,451,464,678,741],"complications,":[34],"yet":[35],"decline":[37],"may":[38,429,473,522,571,636,705,743,797,810],"still":[39,474,744],"occur":[40,716,745],"despite":[41,83,216,264,476,485,531,573,606,680,746,753,823],"prompt":[42,756],"treatment.":[43,212,682,748],"Understanding":[44],"mechanisms":[46,515,765],"treatment-refractory":[48],"loss":[50,109,162,229,397,402,704,752],"remains":[51,403,735],"challenging,":[52],"particularly":[53,783],"when":[54,647,801],"conventional":[55,697],"markers":[56,201,383,652,806],"disease":[58,95,590,641,694,816,832],"activity":[59,96,642,695,833],"are":[60,653,807],"limited.":[61],"We":[62],"present":[63],"biopsy-":[65],"ultrasound-confirmed":[67],"case":[68,468,564,656],"GCA":[70,411,665],"in":[71,90,97,110,230,270,377,422,692,717,737,784,814],"an":[72,535,686],"elderly":[73],"gentleman":[74],"who":[75,674],"developed":[76,152,481],"sequential":[77,482],"bilateral":[78,171,255,343,483,599,820],"central":[79,144,256,436],"retinal":[80,145,257,437],"artery":[81,129,146,168,176,258,339,438,442,604,795],"occlusion":[82,439],"high-dose":[84,218,457,733],"glucocorticoid":[85,219,608,824],"therapy,":[86,220],"highlighting":[87],"important":[88],"considerations":[89],"monitoring,":[91],"imaging,":[92,549],"assessing":[94],"GCA.":[98,513],"Case":[99],"description":[100],"An":[101],"89-year-old":[102],"man":[103],"presented":[104],"with":[105,185,211,249,347,380,392,415,487,499,616,786],"acute":[106,121],"painless":[107],"right":[112,143],"eye.":[113,166,233],"MRI,":[114],"MRA":[115],"CT":[117],"brain":[118],"showed":[119],"no":[120,298,316,385],"cerebrovascular":[122],"pathology.":[123],"Carotid":[124],"Doppler":[125],"demonstrated":[126,170,315,341,368],"50%":[127],"carotid":[128],"stenosis,":[130],"antiplatelet":[132],"therapy":[133,609,825],"was":[134,198,322,352,390,543,595],"switched":[135],"from":[136,431],"aspirin":[137],"to":[138,289,333,359,424,529,588,622,624,676],"clopidogrel.":[139],"Ophthalmological":[140,252],"assessment":[141,649,803],"confirmed":[142,178,254],"occlusion.":[147,259],"Two":[148],"weeks":[149,214,366],"later,":[150,215],"he":[151,221],"pressure-like":[154],"headache":[155],"two":[157],"transient":[158],"episodes":[159],"left":[165,232,391],"Temporal":[167,794],"ultrasound":[169,340,364,605,635,691,796],"halo":[172,349,373,600,630,821],"signs,":[173],"temporal":[175,338,603],"biopsy":[177],"GCA,":[179],"showing":[180],"chronic":[181],"inflammatory":[182,271,382,575,651,727,805],"infiltration":[184],"fragmentation":[186],"internal":[189],"external":[191],"elastic":[192],"laminae.":[193],"Prednisolone":[194],"60":[195,246,489],"mg":[196,242,247,335,361,490],"daily":[197,491],"commenced.":[199],"Inflammatory":[200],"were":[202,287,311,516],"only":[203],"mildly":[204],"elevated":[205,726],"(CRP":[206],"10":[207,334],"mg/L)":[208],"normalised":[210],"Four":[213],"ongoing":[217,780,831],"experienced":[222],"30-minute":[225],"episode":[226],"He":[234,375],"received":[235],"three":[236],"doses":[237],"intravenous":[239,494],"methylprednisolone":[240],"500":[241],"followed":[243],"by":[244],"prednisolone":[245,329,357,488],"daily,":[248,336],"minimal":[250],"improvement.":[251],"reassessment":[253],"Notably,":[260],"deterioration":[262,388,472],"occurred":[263,524],"treatment":[265,486,526,754,836],"without":[267],"rise":[269],"markers.":[272,728],"Following":[273],"multidisciplinary":[274,767],"discussion":[275],"involving":[276],"rheumatology,":[277],"ophthalmology,":[278],"stroke":[279],"physicians":[280],"tertiary":[282],"specialists,":[284],"extensive":[285,546],"investigations":[286],"undertaken":[288],"exclude":[290,779],"alternative":[291,536,763],"causes.":[292],"Echocardiography":[293],"24-hour":[295],"tape":[296],"revealed":[297],"cardiac":[299,550],"source":[300],"embolism.":[302],"Autoimmune":[303],"screening,":[304],"antiphospholipid":[305,555],"antibody":[306,556],"testing":[307],"thrombophilia":[309,552],"screening":[310,553],"negative.":[312],"Histopathological":[313],"review":[314],"evidence":[317],"cholesterol":[319],"embolisation.":[320],"Methotrexate":[321,351],"introduced":[323],"as":[324,540],"steroid-sparing":[326],"agent.":[327],"When":[328],"had":[330],"been":[331],"tapered":[332],"repeat":[337],"persistent":[342,640,787],"vessel":[344],"wall":[345],"inflammation":[346,570],"residual":[348],"signs.":[350],"discontinued,":[353],"azathioprine":[354],"initiated,":[355],"increased":[358],"40":[360],"daily.":[362],"Repeat":[363],"six":[365],"later":[367],"complete":[369],"resolution":[370,627],"sign.":[374],"remained":[376],"clinical":[378,617,648,802],"remission":[379],"normal":[381,574],"but":[389],"permanent":[393],"impairment":[395,420],"independence.":[399],"Discussion":[400],"Visual":[401,703],"one":[404],"feared":[408],"complications":[409,679,742],"associated":[414],"significant":[416,721],"morbidity.":[417],"Permanent":[418],"occurs":[421],"up":[423],"20%":[425],"patients":[427,673,785],"result":[430],"anterior":[432],"optic":[434,452],"neuropathy,":[435],"(CRAO),":[440],"cilioretinal":[441],"occlusion,":[443],"ocular":[444],"syndrome":[446],"or,":[447],"less":[448],"commonly,":[449],"posterior":[450],"neuropathy.":[453],"Prompt":[454,730],"initiation":[455,731],"reduces":[459],"events.":[465],"However,":[466,545],"this":[467],"illustrates":[469],"that":[470,568,633],"progress":[475],"appropriate":[477,747],"therapy.":[478],"Our":[479],"patient":[480],"CRAO":[484],"subsequent":[493],"methylprednisolone.":[495],"His":[496],"initial":[497],"presentation":[498],"isolated":[500],"symptoms":[502,723,788],"few":[504],"features":[506],"highlights":[507,657],"diagnostic":[509],"challenges":[510],"atypical":[512,664],"Several":[514],"considered.":[517],"First,":[518],"vascular":[520,537,548,569,634,690,764,781],"injury":[521],"have":[523,811],"before":[525],"initiation,":[527],"leading":[528],"progression":[530],"adequate":[532],"immunosuppression.":[533],"Second,":[534],"process,":[538],"such":[539],"embolic":[541],"disease,":[542],"explored.":[544],"investigations\u2014including":[547],"assessment,":[551],"testing\u2014did":[557],"not":[558,777],"identify":[559],"another":[560],"cause.":[561],"Third,":[562],"raises":[565],"possibility":[567],"persist":[572],"markers,":[576],"underscoring":[577],"limitations":[579],"relying":[581],"solely":[582],"on":[583,602],"symptoms,":[584],"CRP":[585,773],"ESR":[587,775],"assess":[589],"activity.":[591,817],"A":[592],"challenge":[594],"persistence":[597],"signs":[601,822],"prolonged":[607],"methotrexate.":[611],"Ongoing":[612],"imaging":[613,791],"abnormalities,":[614],"combined":[615],"uncertainty,":[618],"informed":[619],"decision":[621],"switch":[623],"azathioprine.":[625],"Subsequent":[626],"sign":[631],"suggests":[632],"provide":[637,798],"information":[638,800],"about":[639],"guide":[644],"therapeutic":[645],"decisions":[646],"incongruent.":[654],"This":[655],"complexity":[659],"managing":[661],"refractory":[662],"or":[663,724,771,789],"emphasises":[667],"need":[669],"for":[670,689,762],"evaluation":[671],"continue":[675],"develop":[677],"standard":[681],"It":[683],"also":[684],"supports":[685],"emerging":[687],"role":[688,813],"monitoring":[693,815],"beyond":[696],"biomarkers.":[698],"Key":[699],"learning":[700],"points":[701],"\u2022":[702,729,749,769,793,818],"be":[706],"presenting":[708],"feature":[709],"giant":[711],"can":[715],"absence":[719],"markedly":[725],"essential":[736],"suspected":[738],"GCA;":[739],"however,":[740],"Sequential":[750],"should":[755],"reconsideration":[757],"diagnosis,":[760],"investigation":[761],"review.":[768],"Normal":[770],"near-normal":[772],"do":[776],"necessarily":[778],"inflammation,":[782],"concerning":[790],"findings.":[792],"additional":[799],"inconclusive":[808],"Persistent":[819],"methotrexate":[827],"raised":[828],"uncertainty":[829],"regarding":[830],"influenced":[835],"adjustment.":[837]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-04T00:00:00"}
