Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis

Abstract Background Giant cell arteritis (GCA) is a vasculitis of large and medium-sized vessels that causes severe ophthalmic complications. Timely diagnosis and disease monitoring may prevent permanent vision loss but biomarkers for early ocular involvement are scarce. This study evaluates early o...

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Main Authors: Jan Henrik Terheyden, Simon M. Petzinna, Lara C. Burg, Leon von der Emde, Charlotte Behning, Julie Jungblut, Katharina Reinking, Frank G. Holz, Thomas Ach, Maximilian W. M. Wintergerst, Valentin S. Schäfer, Robert P. Finger
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Language:English
Published: BMC 2025-04-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03997-x
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author Jan Henrik Terheyden
Simon M. Petzinna
Lara C. Burg
Leon von der Emde
Charlotte Behning
Julie Jungblut
Katharina Reinking
Frank G. Holz
Thomas Ach
Maximilian W. M. Wintergerst
Valentin S. Schäfer
Robert P. Finger
author_facet Jan Henrik Terheyden
Simon M. Petzinna
Lara C. Burg
Leon von der Emde
Charlotte Behning
Julie Jungblut
Katharina Reinking
Frank G. Holz
Thomas Ach
Maximilian W. M. Wintergerst
Valentin S. Schäfer
Robert P. Finger
author_sort Jan Henrik Terheyden
collection DOAJ
description Abstract Background Giant cell arteritis (GCA) is a vasculitis of large and medium-sized vessels that causes severe ophthalmic complications. Timely diagnosis and disease monitoring may prevent permanent vision loss but biomarkers for early ocular involvement are scarce. This study evaluates early optical coherence tomography (OCT) and OCT angiography (OCTA) biomarkers of ocular involvement in newly diagnosed GCA. Methods Newly diagnosed GCA patients and similarly aged controls were enrolled. Participants underwent ocular examination, including OCT and OCTA imaging of the macula and optic disc. OCT metrics included macular ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (pRNFL) thickness. OCTA parameters included vessel density (VD), vessel skeleton density, and vessel diameter index (VDI). Associations between imaging biomarkers and GCA symptoms (ordinal GCA symptom score) were analyzed using age-adjusted regression models. Results We recruited 23 newly diagnosed GCA patients and 27 controls. VD and VDI in the deep retinal capillaries were significantly higher in GCA compared to controls (p ≤ 0.027). In patients reporting ocular symptoms, GCL thickness, volume and pRNFL thickness were increased in 11%, 22% and 17% of Early Treatment Diabetic Retinopathy Study subfields compared to controls (p ≤ 0.04). Additionally, GCL and pRNFL thicknesses were associated with GCA symptoms (p ≤ 0.041). Conclusions OCT and OCTA imaging revealed structural and perfusion alterations in newly diagnosed GCA patients. Retinal microcirculation was altered, even regardless of the presence of ophthalmic symptoms. Structural changes correlated with systemic manifestations of GCA, suggesting a link between extracranial and intracranial involvement. Our findings underscore the potential diagnostic value of OCT and OCTA biomarkers for ocular involvement in GCA.
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spelling doaj-art-5b7441443e7e48a4be12c22b62cb7f112025-08-20T03:18:53ZengBMCBMC Ophthalmology1471-24152025-04-012511810.1186/s12886-025-03997-xBiomarkers of ocular manifestation in newly diagnosed giant cell arteritisJan Henrik Terheyden0Simon M. Petzinna1Lara C. Burg2Leon von der Emde3Charlotte Behning4Julie Jungblut5Katharina Reinking6Frank G. Holz7Thomas Ach8Maximilian W. M. Wintergerst9Valentin S. Schäfer10Robert P. Finger11Department of Ophthalmology, University Hospital of BonnDepartment of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital of BonnDepartment of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnInstitute for Medical Biometry, Informatics and Epidemiology, University of BonnDepartment of Ophthalmology, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnDepartment of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital of BonnDepartment of Ophthalmology, University Hospital of BonnAbstract Background Giant cell arteritis (GCA) is a vasculitis of large and medium-sized vessels that causes severe ophthalmic complications. Timely diagnosis and disease monitoring may prevent permanent vision loss but biomarkers for early ocular involvement are scarce. This study evaluates early optical coherence tomography (OCT) and OCT angiography (OCTA) biomarkers of ocular involvement in newly diagnosed GCA. Methods Newly diagnosed GCA patients and similarly aged controls were enrolled. Participants underwent ocular examination, including OCT and OCTA imaging of the macula and optic disc. OCT metrics included macular ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (pRNFL) thickness. OCTA parameters included vessel density (VD), vessel skeleton density, and vessel diameter index (VDI). Associations between imaging biomarkers and GCA symptoms (ordinal GCA symptom score) were analyzed using age-adjusted regression models. Results We recruited 23 newly diagnosed GCA patients and 27 controls. VD and VDI in the deep retinal capillaries were significantly higher in GCA compared to controls (p ≤ 0.027). In patients reporting ocular symptoms, GCL thickness, volume and pRNFL thickness were increased in 11%, 22% and 17% of Early Treatment Diabetic Retinopathy Study subfields compared to controls (p ≤ 0.04). Additionally, GCL and pRNFL thicknesses were associated with GCA symptoms (p ≤ 0.041). Conclusions OCT and OCTA imaging revealed structural and perfusion alterations in newly diagnosed GCA patients. Retinal microcirculation was altered, even regardless of the presence of ophthalmic symptoms. Structural changes correlated with systemic manifestations of GCA, suggesting a link between extracranial and intracranial involvement. Our findings underscore the potential diagnostic value of OCT and OCTA biomarkers for ocular involvement in GCA.https://doi.org/10.1186/s12886-025-03997-xGiant cell arteritisImagingOcular biomarkerOptical coherence tomographyOptical coherence tomography angiography
spellingShingle Jan Henrik Terheyden
Simon M. Petzinna
Lara C. Burg
Leon von der Emde
Charlotte Behning
Julie Jungblut
Katharina Reinking
Frank G. Holz
Thomas Ach
Maximilian W. M. Wintergerst
Valentin S. Schäfer
Robert P. Finger
Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
BMC Ophthalmology
Giant cell arteritis
Imaging
Ocular biomarker
Optical coherence tomography
Optical coherence tomography angiography
title Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
title_full Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
title_fullStr Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
title_full_unstemmed Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
title_short Biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
title_sort biomarkers of ocular manifestation in newly diagnosed giant cell arteritis
topic Giant cell arteritis
Imaging
Ocular biomarker
Optical coherence tomography
Optical coherence tomography angiography
url https://doi.org/10.1186/s12886-025-03997-x
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