Takayasu Arteritis Presenting as Bilateral Ocular Ischemic Syndrome

Area of Science:

• Vascular Medicine
• Rheumatology
• Ophthalmology

Background:

• Takayasu arteritis is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
• It often presents with non-specific symptoms, leading to diagnostic delays and potential for severe complications.
• Ocular involvement, such as ischemic syndrome, can be a presenting or early sign of the disease.

Observation:

• A 26-year-old female presented with progressive vision blurring, memory loss, headache, weight loss, and calf claudication.
• Physical examination revealed diminished brachial and radial pulses and light perception visual acuity.
• Imaging demonstrated aortic narrowing and carotid artery stenosis, indicative of large vessel vasculitis.

Findings:

• The patient was diagnosed with Takayasu arteritis complicated by bilateral ocular ischemic syndrome.
• Computed tomography and Doppler ultrasound confirmed significant stenosis in the thoracic aorta and carotid arteries.
• Histopathological confirmation was not described in this case report.

Implications:

• Early diagnosis and treatment of Takayasu arteritis are crucial to prevent irreversible organ damage, including vision loss.
• Aggressive immunosuppressive therapy (e.g., corticosteroids) combined with antiplatelet agents (e.g., aspirin) can lead to clinical improvement and visual recovery.
• This case highlights the importance of considering Takayasu arteritis in young patients with unexplained visual disturbances and signs of large artery involvement.