Zeitschrift für klinische und experimentelle Ophthalmologie
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Giant Cell Arteritis: A Report of Two Cases from Ethiopia

Fisseha Admassu, Yonas Mitku and Wegahta Tesfaye

Background: Giant cell arteritis is a systemic inflammatory vasculitis of unknown etiology that occurs in older persons and can result in a wide variety of systemic, neurologic, and ophthalmologic complications. Giant cell arteritis is a granulomatous necrotizing arteritis with a predilection for large and medium sized arteries. It is considered to be uncommon in the black race with very few reports from Africa. We report two 73 and 74 year old Ethiopian male patients who presented with sudden onset unilateral visual loss that was associated with severe throbbing headache on the affected eye side. Temporal artery biopsy showed characteristic of Giant cell arteritis. Both of our patients were treated with oral prednisolone with no further severe complications from the disease on subsequent follow up for one year. One of our patients developed steroid related complication (high blood sugar) hence monitoring and tapering the dose as soon as possible is of crucial value. The delayed presentation of both the patients has contributed for the poor visual recovery after the treatment.
Conclusion: The two cases that we reported underscored that any new onset headache in an elderly patient should prompt a thorough evaluation for the possibility of GCA regardless of race. Heightened clinical awareness of the possibility of temporal arteritis in black patients should lead to earlier diagnosis and initiation of immunosuppressive therapy.
Setting: University of Gondar Hospital-a tertiary eye care and training center