Case Report: Transient monocular vision loss with isolated paracentral acute middle maculopathy on optical coherence tomography: beware of giant cell arteritis!
Bibliographic record
Abstract
Introduction: We describe a case of transient monocular vision loss (TMVL) and paracentral acute middle maculopathy (PAMM) on optical coherence tomography (OCT) as the only ocular presentation of biopsy-proven GCA. Case description: An 80-year-old woman presented 4 days after an episode of TMVL in the right eye, which lasted for 2 hours and spontaneously resolved. She also had jaw claudication for 1 month. Visual acuity was 20/20 in both eyes, with no relative afferent pupillary defect. Funduscopic examination was normal. Humphrey visual fields (HVF 24-2) were full in both eyes. Spectral domain OCT of the right eye demonstrated a focal lesion with increased hyperreflectivity at the level of the inner nuclear layer, consistent with PAMM. Fluorescein angiography and indocyanine angiography were normal. She was immediately treated with intravenous steroids for presumed giant cell arteritis (GCA), confirmed subsequently by temporal artery biopsy. Conclusion: Most reported GCA patients with PAMM have had permanent vision loss and other obvious funduscopic findings. This unique patient had only TMVL and a normal ophthalmologic examination, including full HVF, and no ischemia on retinal angiographic studies. Immediate macular OCT revealing PAMM in TMVL patients older than age 50 years should suggest GCA and prompt immediate treatment to prevent permanent vision loss.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".