I understand. I thank you so much for giving me all the info during this frustrating time. Again, thank you!!!
WE do not make diagnosis nor assume any medical care of individuals here. You and your MDs will need to make that decision.
JCH MD
Thank you. I had to look up a couple words and read it over and over again, but I finally understand it! But, if it was caused by gca/ta, I am told I need to keep taking prednisone. If caused by a different blockage, prednisone is not necessary? Based on our conversations, I would appreciate your diagnosis. I realize this is difficult without actually being my doctor. Would you continue prednisone or not?
In central retinal emboli or central retinal artery occlusion due to a vasculitis like temporal arteritis if the eye has a cilio-retinal artery coming off the central retinal artery (I believe the % of people that have this is around 10-20%) and if this cilio-retinal artery leaves the CRA posterior to the emboli or vasculitis then you are left with a small sliver of sight remaining. Your description is classic for this. The sighted area is the area supplied by the CR artery.
JCH MD
I now know I am permanently blind in my left eye, but I have a tiny tunnel of good central vision. No perifial vision at all. My doctors tell me it is TA/GCA. I am trying to understand why I have that tiny vision so that I might better understand what happened to me. If I had a central retina artery emboli, wouldn't the eye be totally blind? If it was TA, why were these nerves spared? Appreciate your thoughts.
Again, thank you. My Opthamologist and Neurologist are getting together today and I will find out Thursday what they decide.
It is not likely you have TA with bilateral negative biopsies, no sysmptoms of TA and a realtively normal sed rate and CRA. You might have had a central retinal arterty emboli, or non-arteritic ischemic optic neuropathy.
JCH MD
New developement: I just found out that my Neurologist ordered CRP and ESR tests at the onset of my problem and BEFORE the administration of any Prednizone. The C reactive protein came in at 0.13 mg/L and the Westergren sedimentation rate at 20 mm. Also, the cardid artery sonogram showed only "normal" (I am 66) hardening of the arteries and the heart echogram came back clean. My blood homosyteine is still high at 17, but down from the 24 it used to be (Itake high doses of B6, B12 and Folic acid). My BP is 127/75. Add all this to both temporal autopsies coming back negative, I would very much appreciate your thoughts. My Neurologist thinks it could have been a blockage, even though they never could see one. He does not believe it is GCA. Help if you can!
Good luck. You're welcome
JCH MD
Thank you so much. That info about the two blood tests was exactly what I was looking for. My eye doctor and retina doctor both tell me that even though the biopsies are negative and even though I have no typical symptons, I do "clinically" have Gca. They say nothing else swells the optic nerve like that.
Thank you
bolebu
Generally the taper of steroids is based on the level of two blood tests called CRP and Westergren sedimentation rate and if present clinical symptoms. The section on giant cell arteritis at emedicine is very good. A negative temporal artery biopsy does not rule out GCA.
JCH MD