Ocular Manifestations in an Italian Cohort of Patients with Takayasu Arteritis

Ocul Immunol Inflamm. 2023 Jul;31(5):945-954. doi: 10.1080/09273948.2022.2072348. Epub 2022 May 18.

Abstract

Purpose: We describe ophthalmic manifestations, therapy, and outcomes in 16 patients with Takayasu arteritis (TA).

Methods: Takayasu retinopathy was detected in 15 eyes of 9 patients and hypertensive retinopathy in 14 eyes of 7 patients.

Results: Visual acuity was normal in 7 eyes, 20/40 to 20/200 in 20 eyes, counting fingers in 2 eyes, hand motion in 2 eyes, and no light perception in 1 eye. Glucocorticoids associated with immunosuppressive agents induced a sustained remission in 13 patients. Three relapsing-refractory patients were given the monoclonal antibody tocilizumab, which led to partial and complete response in 1 and 2 patients respectively. Steroid-induced cataracts developed in 4 patients. Restenosis and the consequent recurrence of visual symptoms were detected in 2 of 9 patients who underwent a patency procedure for their stenotic lesions.

Conclusions: Ocular manifestations were a common feature (37.2%) in our cohort of TA patients and were frequently responsible for severe visual deterioration.

Abbreviations: BCVA: best-corrected visual acuity; FFA: fundus fluorescein angiography; GC: glucocorticoids; HR: hypertensive retinopathy; ITAS: Indian Takayasu activity score; OCT: optical coherence tomography; TA: Takayasu arteritis; TR: Takayasu retinopathy.

Keywords: Angiographic revascularization; Takayasu arteritis; Takayasu retinopathy; hypertensive retinopathy; large vessel vasculitis; ocular ischemic syndrome.

MeSH terms

  • Eye
  • Glucocorticoids / therapeutic use
  • Humans
  • Hypertensive Retinopathy* / complications
  • Retinal Diseases* / diagnosis
  • Takayasu Arteritis* / complications
  • Takayasu Arteritis* / diagnosis

Substances

  • Glucocorticoids