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New research · Ophthalmology
Case reports in ophthalmology · 1d
Case reportCase reports in ophthalmology · 2026

Probable Arteritic Posterior Ischemic Optic Neuropathy with Atypical Recovery Secondary to Biologically Occult Giant Cell Arteritis: A Case Report.

Alexandre Balon, Thyago Machado, Mohamed-Amine Ouacha, Aurélie Ledoux
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OphthalmologyCase report

Man with silent giant cell arteritis regained central vision after steroid treatment

Probable Arteritic Posterior Ischemic Optic Neuropathy with Atypical Recovery Secondary to Biologically Occult Giant Cell Arteritis: A Case Report.

Alexandre Balon … Aurélie Ledoux
Case reports in ophthalmology · 2026
Background

Posterior ischemic optic neuropathy (posterior ischemic optic neuropathy) is a rare form of ischemic optic neuropathy, and arteritic posterior ischemic optic neuropathy secondary to giant cell arteritis (giant cell arteritis) usually has a poor prognosis.

Results
0.9
central vision sharpness after treatment, on a scale where 1.0 is normal
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CASE PRESENTATION: We report a rare case of probable arteritic posterior ischemic optic neuropathy secondary to giant cell arteritis with an atypically slow course and remarkable visual recovery.

More results

A 66-year-old man under mild chronic immunosuppression for autologous bone marrow transplantation presented with progressive visual loss and normal inflammatory markers (erythrocyte sedimentation rate [ESR] 14 mm/h, C-reactive protein [CRP] 1.10 mg/L).

Contrast-enhanced orbital and cerebral MRI showed no vasculitic or perioptic abnormalities.

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Conclusion

This case highlights the diagnostic challenge of biologically and radiologically silent giant cell arteritis, the potential modifying role of chronic immunosuppression on disease course and recovery, and the importance of maintaining suspicion for arteritic etiologies and considering temporal artery biopsy even when ESR, CRP, and MRI are normal.

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