Is It Always Better to Get Faster Results in Temporal Artery Biopsies? Invited Commentary Invited Commentary Patricia Chévez-Barrios, MD Diagnosis and treatment of giant cell arteritis (GCA) have narios. Cohen et al demonstrate that the frozen section ap- evolved throughout the years. Before the 1990s, the diagno- proach to the TAB, in their hands, has 83.2% sensitivity and sis relied entirely on temporal artery biopsy (TAB)–proven 99.4% specificity for detecting vascular inflammation consis- disease to start the eyesight-saving steroid treatment. Patholo- tent with active GCA with an overall positivity of 15% of all gists used to do frozen sec- the patients studied. They also show, as an important result tions to rapidly render a diag- applying to everyone working with patients suspected for Related article nosis that would inform the GCA, that the discordance rate of bilateral TABs was 5% to decision of whether or not to have the patient start cortico- 5.5%. This is on the low end of what was previously pub- steroid treatment. This sounds like an ideal practice for lished (3%-40%) and supports the relative low need for bilat- patient care, so why have we stopped favoring this approach? eral synchronous TAB for the diagnosis
JAMA Ophthalmology – American Medical Association
Published: Apr 18, 2021
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