Sir,
Jonas and Harder1 measured the central retinal artery and vein collapse pressure in two groups of patients with anterior ischaemic optic neuropathy (AION). The aim of the study was to evaluate the role of these ophthalmodynamometric measures in differentiating an arteritic from a non-arteritic aetiology.
The giant cell AION group entry criteria need some clarification. Did all patients exhibit the classic symptoms of giant cell arteritis (GCA) as well as elevated inflammatory markers and a positive temporal artery biopsy? When a patient presents with an AION and the classical features of GCA, the diagnosis is not usually challenging.
The issue is whether this change in central retinal artery collapse pressure has the same sensitivity in patients where there are no other clinical features of GCA. In occult GCA, the underlying diagnosis of vasculitis of an AION can be challenging2 and it is in these circumstances where the clinical value of this ophthalmodynamometric test would be useful.
References
Jonas JB, Harder B . Central retinal artery and vein collapse pressure in giant cell arteritis versus nonarteritic anterior ischaemic optic neuropathy. Eye 2008; 22: 556–558.
Hayreh SS, Podhajsky PA, Zimmerman B . Occult giant cell arteritis: ocular manifestations. Am J Ophthalmol 1998; 125: 521–526.
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Aristodemou, P. Comment on central retinal artery and vein collapse pressure in giant cell arteritis vs non-arteritic anterior ischaemic optic neuropathy. Eye 23, 1241 (2009). https://doi.org/10.1038/eye.2008.180
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DOI: https://doi.org/10.1038/eye.2008.180
