Ocular Manifestations of Takayasu’s Arteritis—A Case-Based Systematic Review and Meta-Analysis

Abstract

Takayasu’s arteritis (TA) is a type of vasculitis in which inflammation develops in large vessels, especially in the aorta and its branches. Our study aims to determine the prevalence and type of ocular manifestations in TA. A systematic literature search was conducted in December 2022 using three electronic databases (PubMed, Scopus, and Web of Science). The following data were extracted from each article: the name of the first author; the patient’s age, sex, and origin (continent); circumstances connected with the diagnosis of TA; symptoms given by the patients; reported ocular manifestations; and administered treatment. The final analysis was based on data collected from 122 cases. Retinal ischemia, followed by optic neuropathy, cataract, and retinal artery occlusion, were the most prevalent eye conditions associated with the disease. Systemic steroid therapy, vascular procedures, and methotrexate were mainly used to treat pulseless disease. Patients mostly complained of gradual vision acuity loss, sudden vision acuity loss, ocular pain, and amaurosis fugax. The diagnosis of Takayasu’s arteritis should be considered in patients presenting symptoms of visual decline/loss, ocular pain, or signs of retinal ischemia, optic neuropathy, or early cataract formation. A proper diagnosis is crucial to ensure the patient receives treatment without significant delay.

Evaluation of Choroidal and Retinal Features in Patients with Primary Vasculitis—An Original Optical Coherence Tomography and Optical Coherence Tomography Angiography Study

“…Between 10% and 20% of patients diagnosed with PN develop ophthalmic or neuro-ophthalmic signs and symptoms, whereas in the case of Kawasaki disease (KD), the presence of eye disorders reaches 90% [8,9]. Our findings, described in a systematic review and meta-analysis focusing on ocular manifestations of TA, revealed that in over 74% of the analyzed cases (122 patients), ophthalmic pathologies preceded the diagnosis of TA [10]. Although the association between primary vasculitis and ocular manifestations is well-known, routine ophthalmological examinations for patients with these diseases seem to be lacking, despite the potential for systemic inflammation and ischemia to lead to severe ophthalmic complications.…”

Central Retinal Artery Occlusion Associated with Takayasu Arteritis

“…A study by Pasko et al noted ocular manifestations presenting prior to diagnosis of Takayasu arteritis in 74.6% of cases [3]. This may be explained by cases in which initial manifestations included constitutional symptoms that were non-specific.…”

Retinal Artery Occlusion Associated with Takayasu Arteritis

“…Ocular manifestations of Takayasu arteritis can be seen in a wide range of 8.1-68% of the patients (1). Apart from two case based systematic reviews, current literature is lacking in describing extent of ocular involvement in Takayasu arteritis (1,3). Current classification of Takayasu arteritis does not include visual changes and consequently no ophthalmological examination is recommended even after diagnosis and ocular manifestations can go unnoticed.…”