Background: Takayasu retinopathy is the ocular manifestation of Takayasu arteritis, a vasculitis affecting the aorta and aortic branches. Ocular manifestations are a result of cerebral and ophthalmic nonperfusion, and are noted in 8.1% to 68% of patients with Takayasu arteritis. Management of Takayasu retinopathy relies on treatment of the underlying systemic condition. Case Report: A 60 year old African American male was referred for a comprehensive eye exam after abnormal findings were noted on his diabetic teleretinal exam. Upon clinical examination, the patient was diagnosed with moderate to severe diabetic retinopathy, and a fluorescein angiography was ordered due to the presence of irregular vessels on the optic nerves. Takayasu retinopathy was considered as a differential diagnosis after review of the fluorescein angiography. Further work up with magnetic resonance angiography (MRA) showed no signs of significant stenosis. Conclusion: Takayasu retinopathy is a rare ocular manifestation that can aide in diagnosing a rare and previously undetected systemic disease of Takayasu arteritis. It is important for primary eye care providers to be assertive in performing additional diagnostic tests to prevent misdiagnosis and management of an underlying systemic condition. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/collateral-damage-a-differential-of-takayasu-retinopathy) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.