Chapter 32 - Vasculitis – one example among many

Abstract

The histopathologic classification of vasculitis is usually based on vessel size and whether the inflammation is strongly or weakly associated with an immune-mediated process. Ophthalmologists encounter a range of inflammatory vascular disorders in clinical practice, but giant cell arteritis may be the most common. Although the disease had been recognized for centuries, it was not until 1932 that Bayard Horton described the characteristic pattern of inflammation in the superficial temporal artery. A few years later the vasculitis was linked to vision loss. While medical scientists were searching for an etiology, pathologists were debating what the optimal length of an arterial biopsy should be. The chapter describes milestones in understanding the pathogenesis of giant cell arteritis. The photograph gallery includes the histopathology of age-related changes in muscular arteries, giant cell arteritis, pan-arteritis with necrosis, arteritis of short posterior ciliary arteries, elastic stains in giant cell arteritis, intravascular hemangioma, and inadvertent temporal vein biopsy.