While corticosteroids are the mainstay of treatment in giant cell arteritis (GCA), the type, dose, route and duration of treatment remains controversial. The authors surveyed 180 neuro-ophthalmologists on their use of this treatment via email in a two-month period. Results showed that, for patients with acute visual loss, 52% would use intravenous (IV), 46% would use IV or oral and 2% would use oral corticosteroids. In terms of dosage, 73% would use 500 to 1000mg IV methylprednisolone. For patients without acute visual loss, 67% would use the oral route, 30% IV or oral and 3% IV route of treatment. In this group, 75% would use 1.0 to 1.5mg/kg oral prednisolone. In summary, the survey results suggest a majority consensus for route and dose and confirm conventional recommendations for high dose IV corticosteroids for GCA with visual loss and lower dose oral regimes for GCA without visual loss.
