Visual manifestations in giant cell arteritis: identification of risk factors from the ARTESER Registry
J. Molina Collada, Marta Domínguez-Álvaro, R. González, Elisa Fernández-Fernández, Maite Silva-Díaz, Jesús Alejandro Valero, Ismael González, Julio Sánchez Martín, Javier Narváez, I. Calvo, J. Mendizabal, Lydia Abasolo Alcázar, J. Loricera, Alberto Ruíz-Román, Patricia Moya, Marina Tortosa-Cabañas, Paula Estrada, Francisco Javier Prado-Galbarro, Santos Castañeda, Ricardo Blanco, ARTESER Project Collaborative Group, Clara Moriano Morales, Elvira Díez Álvarez, T. Pérez Sandoval, Vicente Aldasoro Cáceres, M. C. Fito Manteca, N. Del Val del Amo, Loreto Horcada Rubio, I. Paniagua Zudaire, L. Garrido Courel, Ricardo Gutiérrez Polo, Juliana Restrepo Vélez, Eduardo Loza Cortina, Patrícia Carreira, Tomás Almorza, Leticia Léon Mateos, Luis Rodríguez‐Rodríguez, J. Font, Pia Mercedes Lois Bermejo, Tarek Salman Monte, Selene Labrada Arrabal, Anne Riveros-Frutos, Ivette Casafont, Susana Holgado Pérez, Jordi Camins, Clara Molina Almela, Cristina Campos Fernández, Amalia Rueda Cid, Javier Calvo Catalá, Íñigo Hernández Rodríguez, Francisco Maceiras, Nair Pérez, Ceferino Barbazán, José María Pego, Irena Altabás, John Guzman, Vanessa Andrea Navarro Angeles, Hèctor Corominas, I. Castellví, Berta Magallares, Ana Milena Millán, M. Alcalde Villar, Ana F Cruz Valenciano, Félix Cabero del Pozo, Ana Belén Rodríguez Cambrón, Cristina Macía‐Villa, Eva Álvarez de Andrés, Antonio Juan Más, Inmaculada Ros Vilamajó, Monica Ibáñez Barcelo, Elide Toniolo, Ana Paula Cacheda, María Sagrario Bustabad Reyes, María García-González, A. García Dorta, Vanesa Hernández Hernández, Margarida Vasques Rocha, Jaime Calvo Allen, Eugenio de Miguel Mendieta, I Henri, Miren Uriarte-Ecenarro, Cristina Valero Martínez, Esther F Vicente Rabaneda, Carlos Garcı́a-Porrúa, Carlota Laura Iñiguez Ubiaga, Noelia Álvarez Rivas, Tomás Ramón Vázquez Rodríguez, José Alberto Miranda Filloy, Amalia Sanchez-Andrade Fernández, Miguel Á. González‐Gay, Carlos Galisteo Lencastre Da Veiga, Joan Calvet, María Jesús García Villanueva, Carmen Larena Grijalba, Patrícia Álvarez, M. Serrano Warleta, Aliuska Palomeque Vargas, Noemí Garrido, Clara Aguilera Cros, Alejandro Muñoz Jimenez
Abstract
OBJECTIVE: To determine the prevalence and predictive factors of visual manifestations in a large registry of patients with GCA. METHODS: ARTESER is a large Spanish multicentre registry supported by the Spanish Society of Rheumatology. It includes patients with GCA from across the entire country diagnosed between June 2013 and March 2019. The variables collected at diagnosis were demographics, clinical manifestations (including all visual manifestations), laboratory, temporal artery biopsy, and imaging findings (ultrasound, FDG-PET/CT, MRI angiography, CT angiography). Patients with and without visual involvement were compared in a bivariate analysis. Multivariate logistic regression was performed to determine potential predictive factors of visual manifestations. RESULTS: The study population comprised 1636 GCA patients, of whom 599 (36.6%) presented visual manifestations. Anterior ischemic optic neuropathy was the most frequent (n = 274 of 599; 45.7%) ocular complication. The independent predictors that increased the risk (OR; 95% confidence interval) of visual involvement were older age (1.027; 1.009-1.045) and jaw claudication (1.724; 1.325-2.243). The variables associated with a reduced risk were polymyalgia rheumatica (0.541; 0.414-0.708), fever (0.373; 0.264-0.527), longer symptom duration (0.946; 0.909-0.985) and higher erythrocyte sedimentation rate (ESR) (0.992; 0.988-0.997), common features of patients with large vessel GCA. CONCLUSION: One-third of GCA patients present visual manifestations at diagnosis. Older age and jaw claudication are independent predictors of visual manifestations, whereas polymyalgia rheumatica, fever, longer symptom duration and high ESR reduce the risk of visual involvement.