Small vessel disease relagionship to GCA and PMR

[shazstep]

After numerous tests over the last couple of months, including pet scan and mri I have now been diagnosed with Cerebral small vessel disease. My symptoms are so close to GCA as in vision and unable to look up without intense pain, problems tenderness down side of face. My gp upped my preds dose on Friday and within hours symptoms were much improved. I am now left wondering if the symptoms were actually not GCA but Cerebral small vessel disease.

September last year I was admitted to hospital and I could not move my eyeballs without intense pain. Back then my bloods were up but now they are normal.

Has anyone had anything at all similiar? I have now been referred to a Neuro Opthalogist. Is this the best way to go?

Any information would be greatly appreciated.

[PMRpro Ambassador]

I'm not sure who else would manage your care besides a neuro-opthalmologist to be honest and they will certainly know who else to include in your care. It isn't the same as GCA and while a rheumatologist traditionally manages GCA because of the rheumatological symptoms it can cause in the form of PMR, it isn't the right field of expertise for this.

[karegodd]

I was interested in your post. I’ve had PMR since 2017. This past May I developed left eye pain and I went to my optometrist. I complained of eye pain with eye movement especially when looking up. She discovered loss of ocular field in the left upper quadrant. Went to our emerg. Started on60 mg prednisone. CT and orbit mri were ordered and were negative. When I did see the opthamologist it was discovered that I had ocular field loss in the other eye too. At this point nothing has been diagnosed as to the cause and I’m being referred to a neuro opthamologist. It’s strange how it hurts to move the eyeballs especially upwards. I’m just hoping the medical field can figure it out and that there’ll be a strategy to manage it.

[PMRpro Ambassador in reply to karegodd]

Are your eye pressures OK? Did the optician check them? Loss of peripheral vision and raised eye pressures are 2 components of glaucoma - and eye pain may be also present.

[shazstep in reply to PMRpro]

Eye pressure was 22 but she said there was no sign of glaucoma. Today there is no pain just slight blurry vision and I have gone down to 12.5 preds for the next 4 days. I have lost some peripheral vision according to the field test. Still waiting for appointment with neuro-opthalmologist. I think it is more likely to be small vessel disease rather than gca flair. Both can be treated with preds. Why Why Why, I want it all to go away.

Thanks for your concern. I do appreciate this group.

[karegodd in reply to PMRpro]

Thanks for your reply and questions. I was checked by the optometrist (Canada) and all was negative and then again by the opthamologist on call. Pressures were good as was everything else - except the fields and bilateral eye pain.

[oaktree5 in reply to karegodd]

Neuro-opthamalogist when dealing with factors impacting vision, was monitored by one for a year and had good care with extensive feedback.