Occlusive thromboaortopathy (Takayasu's disease): cervical arterial stenoses, retinal arterial pressure, retinal microaneurysms and prognosis.

Abstract

Eighty-one young Japanese patients with occlusive thromboaortopathy (Takayasu's disease) were classed into three groups according to the degree and extent of diameter stenosis in the 4 cervical arterial systems, as determined by serial aortography. Class I was made up of 63 patients with 70% or greater stenosis in less than 3 systems, including 33 patients without systemic hypertension (Class Ia). Class II was made up of 6 patients with 70% or greater stenosis in 3 systems and less than 50% stenosis in the remaining 1, including 5 patients without systemic hypertension (Class IIa). Class III was up of 12 patients with 70% or greater stenosis in 3 systems and 50% or greater stenosis in 1 system. Ophthalmodynamometric systolic pressure in patients in Class III was significantly lower than that in patients in Class IIa (p less than 0.001), but there was no significant difference between patients in Classes Ia and IIa. Microaneurysms and/or arteriovenous anastomoses in the retinal vessels were found in all but one patient in Class III and in only one patient in combined Classes I and II. These results indicate that each of the ophthalmodynamometric values and fundoscopic findings are very helpful in identifying the markedly severe occlusive lesions (Class III) of the 4 cervical arterial systems. In this chronic disease, however, angiography is most useful for evaluation of these severe lesions, to monitor progression from Classes I and II to Class III, in which the prognosis is rather poor.