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Abstract
(1) Background: Takayasu arteritis (TA) is a chronic inflammatory large-vessel vasculitis. Ultra-wide-field imaging allows describing the retinal lesions in these patients and correlating them with vascular supra-aortic stenosis. (2) Methods: In total, 54 eyes of 27 patients diagnosed with TA were included, and a complete ophthalmological examination was performed, including UWF color fundus photography (UWF-CFP), fluorescein angiography (UWF-FA), and computed tomography angiography measuring supra-aortic stenosis. Eleven patients underwent Doppler ultrasound imaging assessing the blood flow velocity (BFV) in the central retinal artery (CRA). (3) Results: Microaneurysms were detected in 18.5% of eyes on fundus examination, in 24.4% of eyes on UWF-CFP, and in 94.4% of eyes on UWF-FA. The number of microaneurysms significantly correlated with the presence of an ipsilateral supra-aortic stenosis (p = 0.026), the presence of hypertension (p = 0.0011), and the duration of the disease (p = 0.007). The number of microaneurysms per eye negatively correlated with the BFV in the CRA (r = −0.61; p = 0.003). (4) Conclusions: UWF-FA improved the assessment of TA-associated retinal findings. The significant correlation between the number of microaneurysms and the BFV in the CRA gives new insight to our understanding of Takayasu retinopathy. The total number of microaneurysms could be used as an interesting prognostic factor for TA.
Highlights
Takayasu arteritis (TA) is a chronic inflammatory large-vessel vasculitis, predominantly affecting the aorta and its main branches [1]
The aims of this study were to assess the retinal manifestations of TA on UWF color fundus photography (UWF-CFP) and fluorescein angiography (UWF-FA), and to investigate the correlation between the severity of retinopathy and the presence of vascular supra-aortic changes
DisTchuissssiotundy showed that UWF-FA allowed better detecting retinal microvascular lesions relatTedhitsosTtuAdcyomshpoawreeddttohUatWUFW-CFF-PF.AInadleloewd,emd ibcreottaenreduerytescmtisnwg ereretidnaetlemctiecdroinvaosncluyla2r4.l4e%soiofnesyerseloanteUdWtoF-TCAFPc,owmhpilaereodn UtoWUFW-FAF,CmFiPc.roInandeeuedry,smmiscrwoearneeduertyescmtesdwine2re2%deotfecctaesdesinat only 24.4% of eyes on UWF-CFP, while on UWF-FA, microaneurysms were detected in 22% of cases at the posterior pole and in 94.4% of cases when all the periphery of the retina was included
Summary
Takayasu arteritis (TA) is a chronic inflammatory large-vessel vasculitis, predominantly affecting the aorta and its main branches [1]. Vessel inflammation leads to wall thickening, fibrosis, stenosis, and thrombus formation [2]. TA primarily affects women, and its incidence varies depending on the geographic area with a predominance in South East Asia [3]. Several related ocular manifestations have been described, such as ocular ischemic syndrome and arterial retinal occlusion. As early as in 1977, Uyama and Asayama [4]. Have defined a retinopathy grading based on the presence of microaneurysms or arteriovenous shunts and, in the most advanced cases, ischemic complications. Most lesions have been described at the posterior pole or in the mid-periphery, depending on the imaging device used
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