[Arterial Doppler in Horton's disease. A prospective study of 24 cases].

The authors studied the role of Doppler ultrasonography in the diagnosis of Horton's disease, the assessment of the ophthalmic risk and the management of therapy. The study involved 24 patients and 20 control patients (mean age: 68 years) without inflammatory arteritis. A score (0 to 3) was established according to the degree of abnormality of blood flow. 12 patients were regularly followed up over a 2 year period. 83 p. 100 of the temporal arteries examined were pathological, 50 p. 100 of which had severe stenoses (scores 2 and 3). The facial, occipital and ophthalmic arteries were commonly involved (79 p. 100 of arteries examined), as was the central artery of the retina (92 p. 100, with 53 p. 100 of scores 2 and 3), although only 15 patients had minor (11 patients) or major (4 patients) ocular symptoms. However, a close correlation was observed between the presence of ocular symptoms and the severity of the stenoses observed on the central artery of the retina. The low incidence of signs of stenosis in the control group explains the excellent specificity of the Doppler examination (95 p. 100). Improvement with steroid therapy took at least 3 months and correlated well with the clinical and biological response. Blood flow changes reverted to normal in 4 patients after 1 year's treatment; 3 patients had relapses which were always associated with aggravation of the Doppler signs of stenosis. This study shows that Doppler ultrasonography is a valuable diagnostic tool, helps establish a prognosis and manage therapy in Horton's disease.