13.3 DisordersthatObscuretheMarginoftheOpticDisk 379 — Prominent temporal arteries in temporal arteritis. -

Differential diagnosis: Arteriosclerotic AION should be considered.

Treatment: Immediate high-dosage systemic steroid therapy (initial doses up to 1000 mg of intravenous prednisone) is indicated. Steroids are reduced as the erythrocyte sedimentation rate decreases, C-reactive protein levels drop, and clinical symptoms abate. However, a maintenance dose will be required for several months. Vascular treatment such as pentoxifylline infusions may be attempted.

H High-dosage systemic steroid therapy (for example 250 mg of intravenous prednisone) is indicated to protect the fellow eye even if a giant cell arteritis is only suspected.

Prognosis: The prognosis for the affected eye is poor even where therapy is initiated early. Immediate steroid therapy is absolutely indicated because in approximately 75% of all cases the fellow eye is affected within a few hours and cerebral arteries may also be at risk.

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Stretch Marks

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