Case Report: A rare case of ocular giant cell arteritis with bilateral orbital inflammation and diagnostic challenges

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Giant cell arteritis (GCA) is a systemic vasculitis that can lead to vision loss if untreated, commonly presenting with headaches and scalp tenderness.
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Bilateral orbital inflammation in GCA is rare and often underrecognized, with fewer than 10 documented cases of perioptic or retrobulbar infiltration.
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A 75-year-old male presented with episodic vision loss and headaches, ultimately diagnosed with GCA after a positive temporal artery biopsy.
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Neuroimaging revealed bilateral retrobulbar/perioptic soft-tissue infiltration, highlighting the diagnostic value of MRI in atypical GCA presentations.
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The case emphasizes the need for improved diagnostic criteria and the potential role of steroid-sparing agents in managing GCA complications.

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