Abstract
A patient with giant cell arteritis and ischaemic optic neuropathy developed bilateral tonic pupils. This pupillary abnormality may result from ischaemia of the ciliary ganglia. Despite the propensity for patients with giant cell arteritis to develop vascular occlusions in the eye and orbit, tonic pupils have rarely been described, and several reasons for this are proposed. The arteries supplying the ciliary ganglia are frequently involved in giant cell arteritis, but their anastomotic pattern may confer protection from ischaemia. Tonic pupils may also be overlooked amidst the more dramatic manifestations of giant cell arteritis.
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Selected References
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- Barricks M. E., Traviesa D. B., Glaser J. S., Levy I. S. Ophthalmoplegia in cranial arteritis. Brain. 1977 Jun;100(2):209–221. doi: 10.1093/brain/100.2.209. [DOI] [PubMed] [Google Scholar]
- Bettelheim H. Die akute Ophthalmomalacie--eine Folgeerscheinung der Arteriitis cranialis. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1968;174(4):359–366. doi: 10.1007/BF00406631. [DOI] [PubMed] [Google Scholar]
- Bevan A. T., Dunnill M. S., Harrison M. J. Clinical and biopsy findings in temporal arteritis. Ann Rheum Dis. 1968 May;27(3):271–277. doi: 10.1136/ard.27.3.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bourgon P., Pilley F. J., Thompson H. S. Cholinergic supersensitivity of the iris sphincter in Adie's tonic pupil. Am J Ophthalmol. 1978 Mar;85(3):373–377. doi: 10.1016/s0002-9394(14)77733-5. [DOI] [PubMed] [Google Scholar]
- Cullen J. F., Coleiro J. A. Ophthalmic complications of giant cell arteritis. Surv Ophthalmol. 1976 Jan-Feb;20(4):247–260. doi: 10.1016/0039-6257(76)90224-1. [DOI] [PubMed] [Google Scholar]
- Cullen J. F. Occult temporal arteritis. A common cause of blindness in old age. Br J Ophthalmol. 1967 Aug;51(8):513–525. doi: 10.1136/bjo.51.8.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davis R. H., Daroff R. B., Hoyt W. F. Tonic pupil after temporal arteritis. Lancet. 1968 Apr 13;1(7546):822–822. doi: 10.1016/s0140-6736(68)92275-7. [DOI] [PubMed] [Google Scholar]
- Edmund J., Jensen S. F. E.R.G. in temporal arteritis. Acta Ophthalmol (Copenh) 1967;45(5):601–609. doi: 10.1111/j.1755-3768.1967.tb06528.x. [DOI] [PubMed] [Google Scholar]
- Elisková M. Blood vessels of the ciliary ganglion in man. Br J Ophthalmol. 1973 Oct;57(10):766–772. doi: 10.1136/bjo.57.10.766. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FISHER C. M. Ocular palsy in temporal arteritis. I. Minn Med. 1959 Sep;42:1258–contd. [PubMed] [Google Scholar]
- Gerstle C. C., Friedman A. H. Marginal corneal ulceration (limbal guttering) as a presenting sign of temporal arteritis. Ophthalmology. 1980 Nov;87(11):1173–1176. doi: 10.1016/s0161-6420(80)35109-9. [DOI] [PubMed] [Google Scholar]
- HOLLENHORST R. W., BROWN J. R., WAGENER H. P., SHICK R. M. Neurologic aspects of temporal arteritis. Neurology. 1960 May;10:490–498. doi: 10.1212/wnl.10.5.490. [DOI] [PubMed] [Google Scholar]
- Hamilton C. R., Jr, Shelley W. M., Tumulty P. A. Giant cell arteritis: including temporal arteritis and polymyalgia rheumatica. Medicine (Baltimore) 1971 Jan;50(1):1–27. [PubMed] [Google Scholar]
- Henkind P., Charles N. C., Pearson J. Histopathology of ischemic optic neuropathy. Am J Ophthalmol. 1970 Jan;69(1):78–90. doi: 10.1016/0002-9394(70)91859-3. [DOI] [PubMed] [Google Scholar]
- Keltner J. L. Giant-cell arteritis. Signs and symptoms. Ophthalmology. 1982 Oct;89(10):1101–1110. doi: 10.1016/s0161-6420(82)34666-7. [DOI] [PubMed] [Google Scholar]
- LOWENSTEIN O., LOEWENFELD I. E. PUPILLOTONIC PSEUDOTABES (SYNDROME OF MARKUS-WEILL AND REYS-HOLMES-AIDE). A CRITICAL REVIEW OF THE LITERATURE. Surv Ophthalmol. 1965 Apr;10:129–185. [PubMed] [Google Scholar]
- Lockshin M. D. Diplopia as early sign of temporal arteritis. Report of two cases. Arthritis Rheum. 1970 Jul-Aug;13(4):419–421. doi: 10.1002/art.1780130409. [DOI] [PubMed] [Google Scholar]
- Loewenfeld I. E., Thompson H. S. The tonic pupil: a re-evaluation. Am J Ophthalmol. 1967 Jan;63(1):46–87. doi: 10.1016/0002-9394(67)90579-x. [DOI] [PubMed] [Google Scholar]
- Martin E. A. Double vision and temporal arteritis. J Ir Med Assoc. 1970 May;63(395):191–193. [PubMed] [Google Scholar]
- McCORMICK H. M., NEUBUERGER K. T. Giant-cell arteritis involving small meningeal and intracerebral vessels. J Neuropathol Exp Neurol. 1958 Jul;17(3):471–478. doi: 10.1097/00005072-195807000-00007. [DOI] [PubMed] [Google Scholar]
- Nielsen N. V., Eriksen J. S. Unusual ocular manifestation in temporal arteritis. A case report. Acta Ophthalmol (Copenh) 1979 Jun;57(3):362–368. doi: 10.1111/j.1755-3768.1979.tb01819.x. [DOI] [PubMed] [Google Scholar]
- PARSONS-SMITH G. Ophthalmic manifestations of temporal arteritis. Br J Ophthalmol. 1952 Nov;36(11):615–625. doi: 10.1136/bjo.36.11.615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Purcell J. J., Jr, Krachmer J. H., Thompson H. S. Corneal sensation in Adie's syndrome. Am J Ophthalmol. 1977 Oct;84(4):496–500. doi: 10.1016/0002-9394(77)90440-8. [DOI] [PubMed] [Google Scholar]
- Thompson H. S. Adie's syndrome: some new observations. Trans Am Ophthalmol Soc. 1977;75:587–626. [PMC free article] [PubMed] [Google Scholar]
- Verdich M., Nielsen N. V. Acute transient ophthalmomalacia in giant-cell arteritis. Report of a case. Acta Ophthalmol (Copenh) 1975 Dec;53(6):875–878. doi: 10.1111/j.1755-3768.1975.tb00405.x. [DOI] [PubMed] [Google Scholar]
- WHITFIELD A. G., BATEMAN M., COOKE W. T. TEMPORAL ARTERITIS. Br J Ophthalmol. 1963 Sep;47:555–566. doi: 10.1136/bjo.47.9.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson I. M., Russell R. W. Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement. Arch Neurol. 1972 Nov;27(5):378–391. doi: 10.1001/archneur.1972.00490170010003. [DOI] [PubMed] [Google Scholar]
- Zion V. M., Goodside V. Anterior segment ischemia with ischemic optic neuropathy. Surv Ophthalmol. 1974 Jul-Aug;19(1):19–30. [PubMed] [Google Scholar]
