Retinal Vascular Changes in Takayasu’s Disease (Pulseless Disease), Occurrence and Evolution of the Lesion

Ocular Ischemic Syndrome

“…In very advanced cases, arteriovenous anastomoses develop progressively from the periphery toward the posterior pole. No retinal hemorrhages were seen by Uyama and Asayama [ 99 ] in their patients, as has also been the experience of others [ 95 , 98 ]. This fact refutes the argument that retinal hemorrhages in eyes with low retinal artery pressure in carotid occlusive disease are due to retinal ischemia.…”

“…In eyes with low pressure in the central retinal artery, there is dilatation of small vessels of the retina, and in advanced cases, there is sludging of circulation in the retinal veins. The microaneurysms, which are seen only in advanced stages of the disease (and are an important sign of this stage), have been described by Uyama and Asayama [ 99 ] as quite different in nature from those seen in diabetic retinopathy. In very advanced cases, arteriovenous anastomoses develop progressively from the periphery toward the posterior pole.…”

“…The fundus fi ndings in patients with pulseless disease vary widely. Uyama and Asayama [ 99 ], based on 79 cases of pulseless disease (Takayasu's disease), classifi ed the disease into three types: (1) disease predominantly involving the aortic arch (38 cases), (2) thoracic or abdominal aorta (16 cases), and (3) a mixture of the previous two types (25 cases). In the fi rst type, there is cerebral hypotension and in the second hypertension in the upper half of the body.…”

Long-Term Survival After Surgical Treatment of Patients With Takayasu’s Arteritis

“…ESR was evaluated before corticosteroid therapy. Retinal findings was divided into 2 categories according to Uyama-Asayama's classification, 13 retinal findings were classified into the group with severe retinal changes. Severe hypertension was defined as a brachial pressure of Ն200 mm Hg systolic or Ն110 mm Hg diastolic or, alternatively, a popliteal pressure of Ն230 mm Hg systolic or Ն110 mm Hg diastolic.…”

Long-term outcome for 120 Japanese patients with Takayasu's disease. Clinical and statistical analyses of related prognostic factors.

“…To adjust for this imbalance, only 51 patients with a major complication were studied, including 11 patients surgically treated and 40 receiving medical treatment alone. The respective 15-year survival rates were 46.7% and 70.4% (Fig 4), with no statistical difference (95% confidence interval, -21.2% to +68.6%).…”