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QJM Advance Access originally published online on April 18, 2006
QJM 2006 99(5):350; doi:10.1093/qjmed/hcl045
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Correspondence

Temporal artery biopsy in ophthalmology: a useful investigation

Sir,

We read with interest the article by Lenton et al. entitled ‘Does temporal artery biopsy influence the management of temporal arteritis?’.1 An audit of temporal artery biopsies carried out over a 13-month period at the Princess Alexandra Eye Pavilion in Edinburgh revealed quite different results. Of the 35 biopsies carried out, 11 (31%) were positive, 23 (66%) were negative and one was inadequate. Of the patients with a negative result, two of the patients who had been started on high-dose corticosteroids prior to biopsy had treatment continued for >3 months, and none were started on steroids after the result became available.

The population involved in our study is quite different from that studied by Lenton et al. All our patients had both presented to and been assessed by an ophthalmologist, and a large proportion had either visual symptoms or temporal headache. However, we also compared our positive biopsy rate with all biopsies carried out by other specialists in Lothian over the same time period, and found a very similar (32%) positive biopsy rate.

In our experience, the biopsy result is generally acted upon and is considered a very useful component of the diagnostic process. Within the department, the decision to biopsy and/or commence corticosteroid treatment is usually made by the team that will be responsible for the patient's longer-term care. The biopsy can be done within 5 days of presentation, and follow-up arranged thereafter with the same team. This integrated approach allows for careful consideration of the indications and potential complications of biopsy, so that when it is considered necessary, the result is generally acted upon.

M. MacRae and A. Tey

Princess Alexandra Eye Pavilion Edinburgh

Reference

1. Lenton J, Donnelly R, Nash JR. Q J Med 2006; 99:33–6.


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
99/5/350    most recent
hcl045v1
Right arrow Alert me when this article is cited
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Right arrow Articles by MacRae, M.
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Right arrow Articles by Tey, A.
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