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Takayasu's arteritis: a unique ophthalmic presentation with CRAO and BRVO

Vinita Gupta1, Saurabh Luthra2, N Shrinkhal1

  • 1Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

BMJ Case Reports
|August 18, 2019
PubMed

Insights

Takayasu's arteritis can present with rare sequential retinal vascular occlusions, including central retinal artery occlusion and branch retinal vein occlusion. Early systemic evaluation is crucial for young patients with these ocular events to diagnose Takayasu's arteritis and prevent vision loss.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Rheumatology

Background:

  • Takayasu's arteritis is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
  • Retinal vascular occlusions, such as central retinal artery occlusion (CRAO) and branch retinal vein occlusion (BRVO), are uncommon manifestations in Takayasu's arteritis, particularly in young patients.

Observation:

  • A case report details sequential CRAO in the left eye and superotemporal BRVO in the right eye of an 18-year-old male diagnosed with Takayasu's arteritis.
  • The patient presented initially with CRAO, underwent cardiovascular evaluation confirming Takayasu's arteritis, was lost to follow-up, and later presented with BRVO.

Findings:

  • The patient experienced sequential CRAO and ST-BRVO, highlighting the potential for diverse retinal vascular involvement in Takayasu's arteritis.
  • Multidisciplinary and ocular interventions resulted in complete visual recovery in the affected right eye, maintained for 2.5 years.

Implications:

  • This case underscores that retinal vascular occlusions, including CRAO and BRVO, can be an inaugural feature of Takayasu's arteritis in young individuals.
  • A high index of suspicion for Takayasu's arteritis is warranted in young males presenting with CRAO or BRVO to enable timely diagnosis and prevent severe visual complications.

Keywords:
Retinacardiovascular medicinecardiovascular systemimmunologyinterventional cardiology

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