An Unusual Case of Giant Cell Arteritis (GCA) Presenting With Bilateral Visual Loss

We report the case of a 77-year-old woman who presented with progressive, painless bilateral visual loss over three weeks. Ophthalmologic evaluation demonstrated bilateral anterior ischemic optic neuropathy and right central retinal artery occlusion. Notably, she lacked classical systemic features of giant cell arteritis (GCA), including headache, scalp tenderness, or jaw claudication. Laboratory evaluation revealed an elevated erythrocyte sedimentation rate (ESR 64 mm/h). Temporal artery ultrasound demonstrated bilateral halo signs, supporting the diagnosis of GCA. High-dose corticosteroid therapy was promptly initiated; however, visual loss remained irreversible. This case highlights the importance of maintaining a high index of suspicion for GCA in elderly patients presenting with unexplained visual symptoms, even in the absence of typical cranial features. Temporal artery ultrasound is a valuable non-invasive diagnostic tool that can facilitate early diagnosis and prompt treatment, potentially preventing irreversible visual complications.