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Painless Visual Loss in a Septuagenarian

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
1 Credit CME

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Article Information

Corresponding Author: Ralph C. Eagle Jr, MD, Department of Neurology and Ophthalmology, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, 840 Walnut St, Ste 1410, Philadelphia, PA 19107 (reagle@willseye.org).

Published Online: March 18, 2021. doi:10.1001/jamaophthalmol.2020.4638

Conflict of Interest Disclosures: None reported.

References
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Jia  L , Couce  M , Barnholtz-Sloan  JS , Cohen  ML .  Is all inflammation within temporal artery biopsies temporal arteritis?   Hum Pathol. 2016;57:17-21. doi:10.1016/j.humpath.2016.07.004 PubMedGoogle ScholarCrossref
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Ghinai  RA , Mahmood  S , Mukonoweshuro  P , Webber  S , Wechalekar  AD , Moore  SE .  Diagnosing light chain amyloidosis on temporal artery biopsies for suspected giant cell arteritis.   J Neuroophthalmol. 2017;37(1):34-39. doi:10.1097/WNO.0000000000000447 PubMedGoogle ScholarCrossref
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Bellavia  D , Pellikka  PA , Al-Zahrani  GB ,  et al.  Independent predictors of survival in primary systemic (Al) amyloidosis, including cardiac biomarkers and left ventricular strain imaging: an observational cohort study.   J Am Soc Echocardiogr. 2010;23(6):643-652. doi:10.1016/j.echo.2010.03.027 PubMedGoogle ScholarCrossref
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Gertz  MA , Comenzo  R , Falk  RH ,  et al.  Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, 18-22 April 2004.   Am J Hematol. 2005;79(4):319-328. doi:10.1002/ajh.20381 PubMedGoogle ScholarCrossref
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