Abstract
A prospective study of continuous-wave Doppler ultrasound was performed on 31 patients with histologically confirmed temporal arteritis (TA). Patients were divided into three groups according to ophthalmoscopy:
group A: no ophthalmic anomalies, 20 cases
group B: nonspecific symptoms, 15 cases
group C: ocular specific lesions of TA, 6 cases (amauroses with optic neuropathy)
Doppler ultrasound showed normal velocity curves in patients of groups A and B. No major morphologic anomalies were obtained. Mean amplitude of systolic peaks was 7.93 mm in group A and 10.30 mm in group B (p/NS), with no significant difference from a reference population of 22 patients with no TA.
Group C had very significant anomalies: no perception of ocular arteries in 1 case, very low blood flow in 4 cases, and disturbances in 1 case. Mean amplitude of systolic peaks was very low: 1.81 mm.
A significant increase in blood velocities was observed after steroid therapy with a normalization of curves in most cases, including patients of group C.
This paper suggests that Doppler ultrasound is the single reliable technique for the evaluation of ophthalmic consequences of TA. It allows discrimination between high-risk patients with anomalies of blood flow in the optic vessels and low-risk patients with normal Doppler curves.
High-risk cases have to be treated vigorously and quickly with high doses of steroids and need regular ultrasonic studies during the first weeks.
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