A 68-year-old Japanese man was introduced to our hospital for optic disc swelling (ODS) in his both eyes (OU). Other than floaters in his right eye, he did not report any symptoms including blurred vision, visual field defect, and ocular pain. Light reflex was prompt and complete OU, and critical flicker frequency was within the normal range OU. By fluorescein angiography, hyperfluorescence was detected on optic discs OU; however, no fluorescein leakage or filling defect was observed. By Goldmann perimetry, enlargement of the Mariotte blind spot was revealed OU, while no central scotoma or remarkable visual field defects were detected. By neuroimaging and lumbar puncture, papilledema due to intracranial pressure elevation was denied. Based on the reassessment of fundus findings, narrowing and segmental whitening/sheathing of peripapillary vessels predominantly to arterioles were realized, and systemic arteritis was suspected. Based on the subject age, elevation of erythrocyte sedimentation rate, positron emission tomography findings in the aorta, and MRI findings in temporal arteries, underlying giant cell arteritis (GCA) was diagnosed. After the start of systemic and local steroid therapies, ODS improved OU. Although rare, bilateral ODS with no visual disturbance can occur in patients with GCA. This case emphasizes the importance of careful assessment of ocular findings to reach the correct diagnosis of even a rare cause of ODS.
Case Rep Ophthalmol 2021;12:675–683

中文翻译：

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双侧视盘肿胀并保留与巨细胞动脉炎相关的视觉功能

一名 68 岁的日本男性因双眼 (OU) 的视盘肿胀 (ODS) 被介绍到我院。除了右眼有飞蚊症外，他没有报告任何症状，包括视力模糊、视野缺损和眼痛。光反射迅速而完全 OU，临界闪烁频率在 OU 正常范围内。通过荧光素血管造影，在视盘 OU 上检测到高荧光；然而，没有观察到荧光素泄漏或填充缺陷。通过戈德曼视野检查，马里奥特盲点的扩大显示为 OU，而没有检测到中央暗点或显着的视野缺损。通过神经影像学和腰椎穿刺，否认颅内压升高引起的视乳头水肿。根据对眼底检查结果的重新评估，实现了主要到小动脉的乳头周围血管变窄和节段性变白/鞘化，并且怀疑是全身性动脉炎。根据受试者年龄、红细胞沉降率升高、主动脉正电子发射断层扫描结果和颞动脉MRI结果，诊断为潜在巨细胞动脉炎（GCA）。在开始全身和局部类固醇治疗后，ODS 改善了 OU。尽管罕见，但 GCA 患者可能会发生没有视觉障碍的双侧 ODS。该病例强调了仔细评估眼部检查结果以正确诊断 ODS 甚至罕见病因的重要性。主动脉的正电子发射断层扫描结果和颞动脉的 MRI 结果，诊断出潜在的巨细胞动脉炎 (GCA)。在开始全身和局部类固醇治疗后，ODS 改善了 OU。尽管罕见，但 GCA 患者可能会发生没有视觉障碍的双侧 ODS。该病例强调了仔细评估眼部检查结果以正确诊断 ODS 甚至罕见病因的重要性。主动脉的正电子发射断层扫描结果和颞动脉的 MRI 结果，诊断出潜在的巨细胞动脉炎 (GCA)。在开始全身和局部类固醇治疗后，ODS 改善了 OU。尽管罕见，但 GCA 患者可能会发生没有视觉障碍的双侧 ODS。该病例强调了仔细评估眼部检查结果以正确诊断 ODS 甚至罕见病因的重要性。
Case Rep Ophthalmol 2021；12:675–683