The optic disc appears pale and swollen, and peripappilarry hemorrhages are seen. Rarer causes of blindness associated with GCA include central retinal artery occlusion or branch retinal artery occlusion. Flame shaped hemorrhages, at or near the disc margin, and cotton-wool spots may be seen. Oculomotor and abducen nerve palsies are relatively common. Therefore, immediate treatment is necessary.
Treatment is with large doses of corticosteroids.
Because the artery will remain positive for biopsy up to 2 weeks after treatment has begun, treatment should not be delayed until a positive biopsy is obtained. A biopsy should always be performed to make certain prolonged treatment with steroids is warranted. In patients highly suspected of having GCA, a negative biopsy of one superficial temporal artery should be followed by a biopsy of the other side.