Central Retinal Artery Occlusion in Takayasu’s Arteritis as the First Presentation of the Disease

Güçlü, Hande; Gürlü, Vuslat; Özal, Sadık Altan; Güçlü, Orkut

doi:10.1155/2016/6492513

Cited by 9 publications

(6 citation statements)

References 10 publications

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“…Noel et al (61) reported a case showing ocular aggravation in 2 months despite the combination of pulse MP and methotrexate, which stabilized after infliximab was added. The remaining 2 patients (one with the combination of pulse MP and methotrexate) became completely blind after treatments (46,55). The only patient diagnosed with RVO was treated with oral steroids and methotrexate, showing stabilized vision despite the occurrence of steroid-related glaucoma and cataract (61).…”

Section: Outcomes Of Medical Therapy Alonementioning

confidence: 99%

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Zeng

Duan

et al. 2022

Front. Immunol.

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BackgroundTakayasu’s arteritis (TA) is a rare, chronic granulomatous large-vessel vasculitis that can lead to ocular ischemia. Ocular outcomes after therapeutic management in TA remain largely unknown. We herein conduct a case-based systematic review to address the current treatment options in this particular cohort.MethodsPubMed, Medline, and EMBASE databases were searched pertaining to ocular outcomes after systemic treatment in TA. Studies reporting ocular examinations before and after treatment in TA patients with ocular ischemia were included. Clinical characteristics, therapies, ocular outcomes, and complications were recorded.ResultsA 29-year-old woman with newly diagnosed TA showed dramatic regression of Takayasu’s retinopathy (TR) following balloon angioplasty. Optical coherence tomography angiography (OCTA) was used as a novel strategy for subsequent follow-up. A total of 117 eyes of 66 patients with a median age of 27 years were included for systematic review. TR was the most common ocular manifestation. Oral steroids were prescribed in nearly all patients (n = 65), followed by the use of methotrexate and antiplatelet therapy. Of the patients, 65.8% and 34.2% underwent open surgery and endovascular procedure, respectively. The median follow-up period was 12 weeks (interquartile range 8–33.5). Surgical therapy showed better ocular improvement (including visual and imaging responses) in both acute and chronic vision loss, along with fewer complications than medical therapy alone. In the surgical group, the visual prognosis was significantly better in patients with initial visual acuity better than 20/200 (p = 0.03) and those who underwent surgery before stage III TR (p = 0.01). Ocular outcomes were equivalent in the two surgical approaches.ConclusionClinicians should be familiar with ophthalmic manifestations of this potentially treatable complication in TA. Compared with medical therapy alone, surgical intervention might be a better choice for both acute and chronic vision loss. Surgery is best recommended before the onset of irreversible ischemia to the globe. A combined regimen (oral steroids, immunosuppressants, and antiplatelet drugs) might be effective for those with surgical contradictions or reluctance to an invasive procedure. Physicians should be aware of the importance of ocular examinations, including OCTA, during the diagnosis and follow-up in TA.

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Section: Outcomes Of Medical Therapy Alonementioning

confidence: 99%

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Zeng

Duan

et al. 2022

Front. Immunol.

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“…Vascular occlusion with ischemic changes[ 17 36 37 ] or as an isolated retinal finding has been described. [ 38 39 40 ] Analysis showed that out of 416 eyes, five had branch retinal artery occlusion (BRAO) (1.20%), two (0.48%) had branch retinal vein occlusion (BRVO), and 6 (1.44%) had central retinal artery occlusion (CRAO). There are two case reports[ 17 32 ] from India with BRAO in a 40-year-old lady and a 16-year-old girl with TA.…”

Section: Discussionmentioning

confidence: 99%

“…Supplementary material 4 gives details of the studies included for analysis of various parameters. [ 2 3 5 6 7 8 11 12 13 14 15 17 18 19 20 26 29 30 31 32 33 34 35 36 38 39 40 41 42 44 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 65 66 68 69 70 71 72 74 75 76 77 78 83 84 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 ]…”

Section: Discussionmentioning

confidence: 99%

Posterior segment manifestations of Takayasu arteritis: A narrative review

Sharma,

Rishi,

Rishi

et al. 2024

Indian Journal of Ophthalmology

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Ocular symptoms can be the presenting manifestation of Takayasu arteritis (TA) or could be indicative of disease reactivation. A review of published literature related to posterior segment manifestations of TA by using the keywords “Takayasu arteritis,” “ophthalmic manifestations,” “retina,” “retinopathy,” “ocular,” “optic nerve,” and “optic neuropathy” was performed. In total, 62 case reports and 12 case series were included. The majority of the articles were from Asia (n = 47, 64%). Females outnumbered males in the ratio of 7:1. The mean age of patients was 33 years (range: 8–78 years, SD: 13.5 years). In 58% (n = 41 out of 71) cases, ocular symptoms were the presenting manifestation of the underlying disease. Hypotensive retinopathy was found in 70% of eyes, and hypertensive retinopathy was found in 27%. The mean presenting visual acuity (VA) was +1.03 logMAR (range: −0.12 to 3, SD: 1.07), and at the final follow-up was +1.02 logMAR (range: −0.12 to 3, SD 1.17). VA improved in 34% (n = 29/86), remained stable in 45% (39/86), and worsened in 21% (18/86). The mean follow-up was 9 months (range: 0.5–204, SD: 16 months).

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“…The most common ocular symptom is vision loss, but it is not unusual that the first symptoms of ocular ischemia are episodes of amaurosis fugax [4, 11]. Occlusive retinal vasculitis or retinal artery occlusions and ischemic optic neuropathy have been reported [7, 12–14]. Cases of episcleritis and scleritis have also been described [15–18].…”

Section: Large Vessel Vasculitismentioning

confidence: 99%

Systemic Vasculitis and Its Association with the Eye

Carreño¹,

Olivas-Vergara²

2023

Ophthalmologica

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Vasculitis are a group of diseases characterize by the inflammation of the blood vessel walls. They are classified according to the size of the main vessel involved: in large vessel, medium vessel, and small vessel vasculitis. Ophthalmic manifestations are quite common in most of these diseases. Being episcleritis and scleritis the most prevalent manifestation of vasculitis. However, there are certain ocular diseases especially characteristic of specific vasculitis entities. Given the severity and potential life-threat of these diseases, knowledge of the ocular manifestations is mandatory for the ophthalmologists.

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Central Retinal Artery Occlusion in Takayasu’s Arteritis as the First Presentation of the Disease

Cited by 9 publications

References 10 publications

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Posterior segment manifestations of Takayasu arteritis: A narrative review

Systemic Vasculitis and Its Association with the Eye

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