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Occult temporal arteritis. A common cause of blindness in old age.

1967; BMJ; Volume: 51; Issue: 8 Linguagem: Inglês

10.1136/bjo.51.8.513

1468-2079

J F Cullen,

Sarcoidosis and Beryllium Toxicity Research

HORTON, Magath, and Brown (1932), working at the Mayo Clinic, introduced the term temporal arteritis for the disease which we still know by this somewhat in- accurate name.The condition had been recognized for many years before this and Jonathan Hutchinson described a case which was probably one of temporal arteritis in 1890.It is a disease of the older age groups, affecting both sexes equally, seldom seen before 55 years and of increasing incidence in the seventh and eighth decades.In classical temporal arteritis there is swelling, tenderness, and pain over the superficial temporal vessels which are thickened, prominent, often pulseless, and occluded.There are associated general symptoms which may precede the signs in the temples, and these consist of headaches, malaise, anorexia, intermittent pyrexia, and loss of weight, and a raised erythrocyte sedimentation rate is often found.The disease is self-limiting, usually lasting about 6 months, but remissions may occur.The generalized nature of the vascular involvement in this condition has been overlooked in the past but, in recent years, has been re-emphasized, and the so-called complications of the disease-usually ocular and cerebral-are now recognized as part of the widespread arteritic process.Cooke, Cloake, Govan, and Colbeck (1946) were the first to demonstrate this in necropsy material and their cases showed involvement of the aorta and of the coronary, cerebral, subclavian, femoral, mesenteric, and radial arteries.Subsequent reports from elsewhere have confirmed that, although the brunt of the disease is borne by the carotid arteries and their branches, any part of the arterial system can be affected (Heptinstall, Porter, and Barkley, 1954; Harrison, Harrison, and Kopelman, 1955; Lander and Bonnin, 1956; Paulley and Hughes, 1960).Attempts have, therefore, been made to re-name the condition, and such terms as "arteritis of the aged", "cranial arteritis", or "giant cell arteritis" have been put forward, but still the original term persists and will no doubt continue to do so, and continue to mislead the unwary, especially the ophthalmologist, who is thus led to believe that he is to look out for an ocular complication of a typical and obvious condition.