Autoimmune retinopathy after chronic renal allograft rejection.

tient’s baseline anticoagulant therapy contributed to the unusually slow progression of vision loss. A few reports propose beneficial effects of anticoagulation and antiplatelet therapy in GCA-related vision loss. Buono et al reported improvement in acuity and posterior ciliary artery blood flow with the addition of heparin sodium therapy in a patient with progressive visual loss despite corticosteroid therapy for 5 days. A retrospective study of 175 patients with GCA reported that patients taking aspirin had fewer cranial ischemic complications at admission and that fewer such complications developed, compared with patients not taking aspirin. The protective effect of aspirin therapy and improvement of vision and blood flow with heparin therapy imply that thrombosis may contribute to vision loss in patients with GCA. However, more studies are needed to validate the beneficial effects of anticoagulant therapy. Visual loss secondary tochoroidal ischemiahasbeenpreviouslydescribed in GCA. One report described visual loss secondary to isolated choroidal nonperfusionover1to2days.Thepatient’svisionimprovedwithhigh-dose corticosteroidtherapy.Anotherarticle described 3 patients with vision loss from choroidal ischemia that progressedoverthecourseofseconds,several hours, and 3 days, respectively. Thevisualdecline inpatientswith GCAtypicallyoccursquickly,overthe course of seconds to days. In our patient,visionloss fromchoroidal ischemiasecondarytoGCAprogressedover 24 days. Giant cell arteritis must be considered in older patients with slowly progressive vision loss.