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A giant escape
  1. Jasvir Virdee,
  2. John Horsburgh,
  3. Marianne Roque,
  4. Susan Mollan
  1. Neuro-ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Jasvir Virdee, Neuro-ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2PR, UK; jasvir.virdee{at}

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Cotton wool spots (CWSs) are a known clinical finding in giant cell arteritis (GCA) when it presents with visual loss secondary to arteritic anterior ischaemic optic neuropathy. To our knowledge a single CWS, prior to visual loss is a unique presentation for cranial GCA in the English language literature. Clinicians should evaluate all patients with amaurosis fugax for GCA and the presence of even one cotton wool patch should prompt further evaluation including either cranial ultrasound and/or temporal artery biopsy.

A 74-year-old Caucasian woman was investigated for …

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  • Contributors JV wrote the manuscript along with JH, JH also helped to plan the case report, MR helped to write the case and find case information. SM found the case, took consent of patient and approved final manuscript and is responsible as overall guarantor of the manuscript content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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