Comparison between findings in ‘active’ or ‘healed’ giant cell arteritis
Reviewed by Claire Howard

Giant cell arteritis (GCA) is the most common systemic vasculitis in older people and can cause devastating sight loss if untreated. Temporal artery biopsy is often relied upon for diagnosis by ophthalmologists, with a positive biopsy result indicating whether the condition is reported as ‘active’ or ‘healed’. Despite many pathological differences between active and healed arteritis, few studies have examined the differences between these two groups with regard to clinical presentation, treatment, and outcomes. The objective of this study was to look for differences in clinical presentation between patients with healed and active arteritis at the time of biopsy. Retrospective medical chart review of 85 patients found 80% had active and 20% had healed disease according to histopathology. A higher percentage of those with active arteritis had ischaemic optic neuropathy, elevated erythrocyte sedimentation rates, elevated C-reactive protein levels, GCA risk score > 7.5% and higher mean GCA risk calculator scores. Patients with healed arteritis were less likely to have visual manifestations than the active arteritis group. As this research is retrospective in nature and single-site, the authors acknowledge that further multi-centre research is needed regarding correlation of biopsy findings and risk of complications or relapses.

Presenting features of giant cell arteritis with active versus healed arteritis on biopsy.
Sun E, Li X, Gruener AM, et al.
NEURO-OPHTHALMOLOGY
2023;47(3):129–35.