A 76-year old African American female with a history of arteritic ischemic optic neuropathy (AION) secondary to biopsy-proven giant cell arteritis (GCA) presented with unilateral vision loss in her contralateral eye despite high-dose oral steroid treatment. Dilated fundus examination revealed three cotton wool spots. Fluorescein angiography showed slowed arteriolar filling with late staining of small peripheral arteries, consistent with small vessel arteritis. Laboratory tests for alternative vasculitides were negative. Review of her temporal artery biopsy specimen confirmed lymphoplasmacytic inflammation around small adventitial vessels with no destructive granulomatous or leukocytoclastic small vessel vasculitis, consistent with GCA. Our unique case demonstrates peripheral small vessel retinal arteriolar leakage in GCA, which is a rare finding. This association is of interest because GCA is commonly associated with medium to large vessel pathology without small vessel involvement.

中文翻译：

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巨细胞性动脉炎周围视网膜小动脉渗出：一例报告

一名76岁的非洲裔美国女性，尽管经大剂量口服类固醇治疗，但在活检证实的巨细胞动脉炎（GCA）之后继发了动脉缺血性视神经病变（AION），但单侧视力丧失。眼底扩大检查发现三个棉线斑点。荧光素血管造影显示小动脉充盈减慢，末梢小动脉染色较晚，与小血管动脉炎一致。替代性血管紧张素的实验室检查为阴性。回顾她的颞动脉活检标本，证实小外膜血管周围有淋巴胞浆性炎症，无破坏性肉芽肿或白细胞碎裂小血管炎，与GCA一致。我们的独特病例显示了GCA周围小血管视网膜小动脉渗漏，这是罕见的发现。