Clinical and color Doppler imaging features of one patient with occult giant cell arteritis presenting arteritic anterior ischemic optic neuropathy

Vol. 57 No. 2 Suppl., 2016
This supplement was not sponsored by Outside Organizations.

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Dragos Catalin Jianu, Silviana Nina Jianu, Ligia Petrica, Andrei Gheorghe Marius Motoc, Traian Flavius Dan, Dorela Codruta Lazureanu, Mihnea Munteanu

Anterior ischemic optic neuropathies (AIONs) represent a segmental infarction of the optic nerve head (ONH) supplied by the posterior ciliary arteries (PCAs). Blood supply blockage can occur with or without arterial inflammation. For this reason, there are two types of AIONs: non-arteritic (NA-AION), and arteritic (A-AION), the latter is almost invariably due to giant cell arteritis (GCA). GCA is a primary vasculitis that predominantly affects extracranial medium-sized arteries, particularly the branches of the external carotid arteries (including superficial temporal arteries - TAs). One patient with clinical suspicion of acute left AION was examined at admission following a complex protocol including color Doppler imaging (CDI) of orbital vessels, and color duplex sonography of the TAs and of the carotid arteries. She presented an equivocal combination of an abrupt, painless, and severe vision loss in the left eye, and an atypical diffuse hyperemic left optic disc edema. She had characteristic CDI features for GCA with eye involvement: high resistance index, with absent, or severe diminished blood flow velocities, especially end-diastolic velocities, in all orbital vessels, especially on the left side (A-AION). Typical sonographic feature in temporal arteritis as part of GCA was dark halo sign. On the other hand, she did not present classic clinical or systemic symptoms of GCA: temporal headache, tender TAs, malaise (occult GCA). The left TA biopsy confirmed the diagnosis of GCA. The ultrasound investigations enabled prompt differentiation between NA-AION and A-AION, the later requiring in her case immediate steroid treatment, to prevent further visual loss in the right eye.

Corresponding author: Andrei Gheorghe Marius Motoc, MD, PhD; e-mail: amotoc@umft.ro

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Anca Maria Raducanu, Ion-Victor Feraru, Ioana Suciu, Elina Teodorescu, Andreea Cristiana Didilescu, Ileana Ionescu, Ecaterina Ionescu

Bicuspid aortic valve (BAV) is the most common congenital abnormality of the heart. In this condition, instead of three cusps, the aortic valve has two cusps. Children with congenital heart diseases are at increased risk of developing oral diseases, such as: higher number of decayed teeth, developmental anomalies, periodontal disease, malocclusion, dental crowding, as well as susceptibility to develop infective endocarditis from bacteremia caused by chronic poor oral health. However, little information is available regarding oral manifestations and their management in patients with congenital heart defects, despite the importance of these diseases. This paper presents oral manifestations associated with BAV in a young patient, alongside the general features of the condition. The presented case with BAV brings together features of a complex pathology and multidisciplinary treatment, which was conducted over a long period of time and still continues nowadays.

Corresponding author: Ion-Victor Feraru, Lecturer, DDS, PhD; e-mail: victor.feraru@gmail.com

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