Ocular manifestations of Takayasu arteritis

Abstract

AbstractPurpose Takayasu arteritis is an inflammatory vascular disease of aorta and its branches. Ophthalmologic manifestations can occur up to 68% of patients and can be inaugural. The objective of this series is to describe the typical and atypical ocular manifestations of the diseaseMethods Bicentric (Pitié‐Salpêtrière and Lariboisière Hospitals) and multidisciplinary retrospective study conducted between 2004 and 2012, describing ocular manifestations of patients with Takayasu arteritis.Results Seven patients, 3 men and 4 women, were included. Mean age was 51(range:31‐70 years). Five patients had previously a confirmed diagnosis of Takayasu (71% type V) and 2 presented with inaugural ocular involvement. Most of the patients were asymptomatic(42%). We identified 5 typical manifestations , including 3 Takayasu retinopathy (42%),1 hypertensive retinopathy(15%) and 1 mixed retinopathy (15%). Atypical manifestations included a bilateral central retinal artery occlusion, a branch retinal vein occlusion and a transient monocular blindness. Treatment consisted of systemic administration of corticosteroids and immunosuppressors, symptomatic and secondary preventive therapy (laser photocoagulation on ischemic areas). Takayasu arteritis causes various ophthalmic manifestations such as traditional hypoperfusion retinopathy and hypertensive retinopathy. Atypical cases have been described, such as venous or arterial occlusions, ischemic neuropathy, and for the first time in our series a case of inaugural bilateral central retinal artery occlusion.Conclusion Takayasu arteritis should be considered in young patients with atypical vascular or inflammatory retinal manifestations. Collaboration with internists is mandatory in order to diagnose systemic involvement and propose the best therapeutic approach.