Visual Manifestations in Giant Cell Arteritis: Identification of Risk Factors from the ARTESER Registry

Juan Molina-Collada¹, Marta Domínguez², Rafael Benito Melero-Gonzalez³, Elisa Fernandez-Fernandez⁴, Maria. T Silva-Diaz⁵, Joaquín M. Belzunegui⁶, Ismael González⁷, Julio Sanchez Martin⁸, Javier Narvaez⁹, Eva Galíndez¹⁰, javier Mendizábal¹¹, Leticia Leon Mateos¹², Javier Loricera⁸, Alejandro Muñoz¹³, Santos Castañeda¹⁴, Iván Castellvi¹⁵, Marina Tortosa-Cabañas¹⁶, Vanesa Navarro¹⁷, Carlos Galisteo¹⁸, Ivette Casafont-Solé¹⁹, Jose Andres Roman Ivorra²⁰, TAREK CARLOS SALMAN MONTE²¹, Margarida Rocha²², Carlota Laura Iñiguez²³, Maria Vanesa Hernandez Hernandez²⁴, Cristina Campos²⁵, María Alcalde²⁶, Antonio Juan Mas²⁷, Francisco Javier Prado²⁸ and Ricardo Blanco²⁹, ¹Hospital General Universitario Gregorio Marañón, Madrid, Spain, ²Sociedad Española de Reumatología, Madrid, Spain, ³CHU Vigo, O Carballino, Spain, ⁴La Paz University Hospital, Madrid, Spain, ⁵Complexo Hospitalario Universitario A Coruña, A Coruña, Spain, ⁶Hospital Universitario Donostia, Donostia, Spain, ⁷Hospital Universitario de León, León, Spain, ⁸Hospital Universitario Marqués de Valdecilla, Santander, Spain, ⁹Hospital Universitario de Bellvitge, Barcelona, Spain, ¹⁰Hospital Universitario de Basurto, Bilbao, Spain, ¹¹Complejo Hospitalario de Navarra, Pamplona, Spain, ¹²IDISSC Hospital Clinico San Carlos, Madrid, Spain, ¹³Hospital universitario Virgen del Rocío, El Viso de Alcor, Spain, ¹⁴Hospital Universitario de la Princesa, Madrid, Spain, ¹⁵Hospital de Santa Creu i Sant Pau, Barcelona, Spain, ¹⁶Ramon y Cajal University Hospital, Madrid, Spain, ¹⁷H Moisès Broggi, Sant Joan Despí, Barcelona, Spain, ¹⁸Hospital Universitario Parc Taulí, Barcelona, Spain, ¹⁹Hospital Germans Trias i Pujol, Badalona, Spain, ²⁰Hospital Universitari i Politècnic la Fe, Valencia, Spain, ²¹Hospital del Mar/Parc de Salut Mar-IMIM, Barcelona, Spain, ²²Osakidetza, Bilbo, Spain, ²³Hospital Universitario Lucus Augusti, Lugo, Spain, ²⁴Hospital Universitario de Canarias, La Laguna, Spain, ²⁵Rheumatology Unit, Hospital General Universitario de Valencia, Valencia, Spain, ²⁶Hospital Severo Ochoa, Madrid, Spain, ²⁷Hospital Universitario Son Llàtzer, Mallorca, Spain, ²⁸Research department Hospital Infantil de México Federico Gómez, Mexico City, Mexico, ²⁹Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain

Meeting: ACR Convergence 2023

Keywords: giant cell arteritis, risk factors, Vasculitis

Session Information

Date: Tuesday, November 14, 2023

Title: (2387–2424) Vasculitis – Non-ANCA-Associated & Related Disorders Poster III

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Visual loss is one of the most feared complications in giant cell arteritis (GCA). Some factors have been previously associated with visual loss, as lower levels of inflammatory markers, jaw claudication or thrombocytosis, although some of these studies showed contradictory results. Our objective was to identify predictive factors of visual involvement in a large cohort of patients with GCA.

Methods: ARTESER is a large Spanish multicenter registry promoted by the Spanish Society of Rheumatology, including patients with GCA diagnosis from June 2013 to March 2019. The following variables were collected at diagnosis per protocol: demographics, symptoms (including all visual manifestations reported by clinicians), laboratory test results, temporal artery biopsy and imaging techniques (ultrasound, PET, MRI, CT).Patients with and without visual involvement were compared in a bivariate analysis. Multivariate logistic regression model was performed to determine potential predictive factors of visual manifestations.

Results: A total of 1636 GCA patients were included for analysis, of whom 599 (36.6%) presented visual involvement. The most frequent visual manifestation was anterior ischemic optic neuropathy (45.7%), followed by transient monocular vision loss (45.1%). Clinical, laboratory and imaging variables of patients with and without visual symptoms are shownin Table 1. Older age (OR 1.029; 95% CI 1.011-1.048), jaw claudication (OR 1.747; 95% CI 1.343-2.271) and diabetes mellitus (OR 1.358; 95% CI 0.994-1.854) were the only independent predictors of visual symptoms in our cohort. The presence of polymyalgia rheumatica (OR 0.498; 95% CI 0.383-0.648), fever (OR 0.393; 95% CI 0.274-0.563) and higher erythrocyte sedimentation rate (ESR) (OR 0.993; 95% CI 0.989-0.998) were associated with a reduced risk of developing visual involvement (Table 2).

Conclusion: One out of every three GCA patients present visual manifestations at diagnosis. Older age, jaw claudication and diabetes mellitus are independent predictors of visual manifestations, whereas polymyalgia rheumatica, fever and high ESR reduces the risk of visual involvement.

Table 1. Clinical, laboratory and imaging variables of patients with GCA according to presence of visual manifestations.

Table 2. Logistic regression analysis of factors associated with visual manifestations.

Disclosures: J. Molina-Collada: None; M. Domínguez: None; R. Melero-Gonzalez: None; E. Fernandez-Fernandez: None; M. Silva-Diaz: None; J. Belzunegui: None; I. González: None; J. Sanchez Martin: None; J. Narvaez: None; E. Galíndez: None; j. Mendizábal: None; L. Leon Mateos: None; J. Loricera: None; A. Muñoz: None; S. Castañeda: None; I. Castellvi: None; M. Tortosa-Cabañas: None; V. Navarro: None; C. Galisteo: None; I. Casafont-Solé: None; J. Roman Ivorra: None; T. SALMAN MONTE: None; M. Rocha: None; C. Iñiguez: None; M. Hernandez Hernandez: None; C. Campos: None; M. Alcalde: None; A. Mas: None; F. Prado: None; R. Blanco: AbbVie, 5, 6, Amgen, 6, AstraZeneca, 2, BMS, 6, Eli Lilly, 6, Galapagos, 2, 6, Janssen, 2, 6, MSD, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 5, 6, Sanofi, 6.

To cite this abstract in AMA style:

Molina-Collada J, Domínguez M, Melero-Gonzalez R, Fernandez-Fernandez E, Silva-Diaz M, Belzunegui J, González I, Sanchez Martin J, Narvaez J, Galíndez E, Mendizábal j, Leon Mateos L, Loricera J, Muñoz A, Castañeda S, Castellvi I, Tortosa-Cabañas M, Navarro V, Galisteo C, Casafont-Solé I, Roman Ivorra J, SALMAN MONTE T, Rocha M, Iñiguez C, Hernandez Hernandez M, Campos C, Alcalde M, Mas A, Prado F, Blanco R. Visual Manifestations in Giant Cell Arteritis: Identification of Risk Factors from the ARTESER Registry [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/visual-manifestations-in-giant-cell-arteritis-identification-of-risk-factors-from-the-arteser-registry/. Accessed .

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