Abstract

A 77-year-old man with mild headache and sudden vision loss (no light perception) in his right eye was referred for giant cell arteritis (GCA). Fundoscopy revealed chalky white optic disc edema, focal retinal edema, and 2 Hollenhorst plaques (HHP) in the distal arcades (Fig A). Choroidal filling was delayed (Fig B). Erythrocyte sedimentation rate was 12 mm/hr; C-reactive protein was 5.02 mg/dl (normal ≤5.00 mg/dl). Neuroimaging demonstrated subclinical infarcts (Fig C) and near complete right internal carotid artery occlusion (Fig D).

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