This study investigates the role of color Doppler ultrasonography (CDUS) in diagnosing giant cell arteritis (GCA) in patients with ischemic optic neuropathy (ION) or retinal artery occlusion (RAO). Distinguishing arteritic from non-arteritic conditions is critical for preventing irreversible bilateral blindness. A retrospective analysis was conducted on 38 patients diagnosed with ION or RAO between 2018 and 2021, all of whom underwent both CDUS and temporal artery biopsy (TAB). The study aimed to evaluate the diagnostic performance of CDUS compared to TAB, using the latter as the reference standard.
The results demonstrated that CDUS had a sensitivity of 65.0% and a specificity of 100%, excluding two inconclusive cases. This indicates that while CDUS may miss some cases of GCA, it reliably ruled out the condition in the majority of patients. In cases where CDUS results were negative or unclear, TAB could be omitted without compromising diagnostic accuracy. Specifically, limiting TAB to only those cases with negative or inconclusive CDUS findings reduced the need for TAB by 42.1% while maintaining 100% sensitivity and specificity. This suggests that CDUS can effectively guide the need for biopsy and potentially avoid unnecessary invasive procedures.
The findings support the use of CDUS as an initial diagnostic tool in suspected GCA cases, leading to a stepwise diagnostic approach that may reduce reliance on TAB. By confirming or ruling out GCA, CDUS could help prevent unnecessary biopsies, minimize patient discomfort, and reduce healthcare costs. The study advocates for incorporating CDUS into clinical protocols, enhancing the efficiency and accuracy of GCA diagnosis in ophthalmic patients presenting with ION or RAO.
