More to it than meets the eye- A case of Takayasu arteritis and antiphospholipid syndrome, associated with ocular ischemic syndrome, neovascularization and secondary angle closure

Abstract

We describe an atypical case of bilateral ocular ischemic syndrome with neovascularization and secondary angle closure in a 28-year-old lady with features of antiphospholipid syndrome (APS) and Takayasu arteritis; the latter being detected on evaluation of the etiology of the ocular condition. She was treated with pan retinal photocoagulation in one eye and anterior retinal cryotherapy in the other eye (due to poor visualization of the retina initially) followed by cataract surgery. Systemic evaluation was done. Takayasu arteritis was detected and appropriate management was advised under specialist care. Her systemic condition was stable, ocular neovascularization was regressing, and visual acuity improved in the pseudophakic eye; a drop in visual acuity due to the progression of cataract and macular ischemia was noted in the phakic eye at follow-up. Timely detection and appropriate management of ocular and systemic conditions in such cases can preserve vision and limit further systemic morbidity.