A National Survey of Practice Patterns Temporal Artery Biopsy

被引:13
|
作者
Schallhorn, Julie [1 ]
Haug, Sara J. [1 ]
Yoon, Michael K. [2 ]
Porco, Travis [1 ]
Seiff, Stuart R. [1 ,3 ]
McCulley, Timothy J. [4 ,5 ]
机构
[1] Univ Calif San Francisco, Dept Ophthalmol, San Francisco, CA USA
[2] Harvard Univ, Massachusetts Eye & Ear Infirm, Sch Med, Boston, MA USA
[3] Calif Pacific Med Ctr, San Francisco, CA USA
[4] Johns Hopkins Univ, Wilmer Eye Inst, Baltimore, MD 21218 USA
[5] King Khalid Eye Specialist Hosp, Riyadh, Saudi Arabia
关键词
GIANT-CELL ARTERITIS; FACIAL-NERVE INJURY; CORTICOSTEROID TREATMENT; THERAPY; YIELD;
D O I
10.1016/j.ophtha.2013.01.052
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: To assess current clinical practice patterns for temporal artery biopsy (TAB) among clinicians in establishing the diagnosis of giant cell arteritis. Design: A survey was sent via e-mail using the Survey Monkey website (www.surveymonkey.com; accessed January 24, 2013). The survey initially was sent in July 2010 and continued through October 2010. Participants: The survey was sent via e-mail to the members and affiliates of the American Society of Ophthalmic Plastic and Reconstructive Surgery, the North American Neuro-Ophthalmology Society, and the American College of Rheumatology. Methods: Data from the survey were collected via Survey Monkey and data analysis was performed using the Fisher exact test and Wilcoxon rank-sum test. Main Outcome Measures: Response to the survey questions on primary unilateral versus bilateral biopsy, performing second-side biopsy if first side results were negative, and the duration for which biopsy findings are reliable after initiating immunosuppressive therapy. Results: The self-described primary subspecialty of the 1074 respondents was as follows: oculoplastic surgery (n = 127), neuro-ophthalmology (n = 119), rheumatology (n = 799), and other (n = 28). Overall, 66% of respondents advocated initial unilateral TAB, 18% advocated bilateral biopsy in all cases, and 16% recommended either unilateral or bilateral TAB depending on the degree of clinical suspicion. Rheumatologists were 4.5 times more likely to advocate initial bilateral biopsy than neuro-ophthalmologists or oculoplastic surgeons (P < 0.0001, Fisher exact test). Most respondents believed that biopsy results were accurate for more than 14 days. These results were not affected by stratification of years in practice by the Kruskal-Wallis rank-sum test. Conclusions: Temporal artery biopsy practices vary greatly among treating physicians. This lack of consensus underscores the need for a systematic assessment of varying practice patterns. (C) 2013 by the American Academy of Ophthalmology.
引用
收藏
页码:1930 / 1934
页数:5
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