Takayasu disease on the centenary of its discovery

Abstract

Takayasu disease was first reported in 1908 by Mikito Takayasu as "a case of peculiar changes in the central retinal vessels." Because in these patients the pulse of the radial artery is impalpable, investigations focusing on the ischemic symptoms of the upper body were conducted. In 1948, Shimizu and Sano named this pathological condition "pulseless disease." Since then, the lesions of Takayasu disease have been detected not only in the aortic arch and its main branches but also in various vessels, including the abdominal aorta and renal arteries. The ocular symptoms of Takayasu disease are considered to be due to ischemia in the retina and choroid. The typical wreath-like arteriovenous anastomosis around the disc reported by Takayasu is observed at a relatively late stage of the disease. The characteristic fundus findings of Takayasu disease include tortuosity and dilatation of the central retinal artery and vein, retinal arteriovenous anastomosis, prominent retinal vasculature, microaneurysms in the capillaries, occlusion of retinal arterioles, soft exudate, choked disc, and optic atrophy. Fluorescein angiography reveals retinal microaneurysms, sludging, slower blood flow, dilatation of retinal vessels, leakage of fluorescence dye due to increased vascular permeability, and arteriovenous anastomosis. Arteriovenous anastomosis initially appears in the periphery at the early stage, and in the arteriovenous crossing at the advanced stage. Systemic administration of corticosteroids is required to prevent vascular stenosis during the early stages of Takayasu disease. Reconstruction of the carotid artery may improve subjective symptoms and fundus findings.

Retrospective analysis of 95 patients with large vessel vasculitis: a single center experience

“…Although TAK was first reported in 1908 by the Japanese ophthalmologist Mikito Takayasu as a case of peculiar changes in the central retinal vessels, the frequency of ION was rare (3.4%) in our patients with TAK. The typical arteriovenous anastomosis around the optic disc reported by Takayasu is now considered to be a late‐stage finding . The reported frequency of ION may be decreasing due to recent advances in imaging modalities, such as enhanced CT, MRA and FDG‐PET, which allow for earlier and more accurate diagnosis of TAK …”

Headache and Whiteout Vision as the Presenting Symptoms in a Case of Takayasu Retinopathy

“…1 Another Japanese ophthalmologist Yoshiakira Ohnishi also described "a case with similar changes in the fundus and impalpable pulse of the radial artery". 2 The fundus changes noted in Takayasu retinopathy were subsequently attributed to ocular ischemia.…”

Die Sache mit den Eigennamen …

“…Abb. 1) zwar Gefäßanastomosen am Augenhintergrund [1], der typische Befund des Pulsverlustes der A. radialis wurde aber von einem anderen Kollegen auf dem gleichen Kongress präsentiert: "Yoshiakira Ohnishi presented "a case with similar changes in the fundus accompanying impalpable pulse of the radial artery" [2]. 1921 wurde der Begriff "Takayasu-Krankheit" von Nakajima eingeführt [3].…”