Ocular manifestations associated with takayasu arteritis: a multimodal imaging study

Abstract

PurposeThe goal of this study was to describe ophtalmological features of Takayasu disease on fundus exam, in fluorescein angiography and OCT angiography.MethodsAll patients diagnosed with Takayasu disease and followed in la pitié salpétrière hospital from 2004 to 2016 were restrospectively included. They underwent a complete ophtalmological exam including best correct visual acuity, slit‐lamp biomicroscopy, fundoscopy and multimodality imaging including fluorescein angiography and SD OCT. Most patients underwent OCT angiography.The images were analyzed to evaluate perifoveal anastomotic capillary arcade disruption, capillary perifoveolar density, mivroaneurysms. The foveal avascular zone (FAZ) was measured for superficial (SCP) and deep (DCP) capillary plexus.Results26 eyes were included. Most frequent anomalies were retinal microaneurisms (6 patients). Stage I retinopathy was seen in 5 eyes; stage II in 10, stage III in 2 and stage IV in 3 eyes. 14 eyes underwent OCT Angiography. 11 eyes of 6 patients presented with ruptures of the perifoveal anastomotic capillary arcade in SCP. 5 eyes had microaneurysms. 11 eyes of 6 patients had rarefaction of the perifoveolar vascular density in SCP. The average measure of the SCP FAZ was increased to 0.34 mm2 (0.19–0.74) in takayasu patients compared to 0.27 mm2 (0.18–0.33) in the patients with no maculopathy.ConclusionsMacular abnormalities are uncommon in patients with Takayasu disease as the retinopathy signs are most likely located in the peripheric retina. This study reveals that most of our patients present an enlargement of the FAZ, even in the earliest stages of retinopathy with no macular abnormality on fluorescein angiography. The study finally highlights the relevance of using OCT A to evaluate the macular ischemia as a complement to usual retina global study in fluorescein angiography.