Do not taper if treated for In prolonged treatment, taper over 1-2 wk. Prescribe a sufficient quantity of steroids to ensure proper compliance. Symptoms should begin to resolve within 1-3 days. Duration of maintenance therapy may last for 1 year or more, depending upon the patient's response. Methotrexate or azathioprine may act as steroid sparing agents.
Loss of vision is the most feared complication of misdiagnosed or untreated temporal arteritis.
Temporal arteritis not only impairs sight in the affected eye, but also up to three quarters of patients with unilateral blindness lose vision in the contralateral eye within 3 weeks. Risk of thoracic aneurysms is 17 times higher in patients with temporal arteritis than in age-matched controls. Patients with temporal arteritis are at twice the risk of abdominal aneurysms as those in the control population. Encourage immediate follow-up care to discuss future need for temporal biopsy. Explain that existing loss of visual perception may not be regained, despite therapy.