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Ocular findings and blood flow in patients with Takayasu arteritis: a cross-sectional study
  1. Fehim Esen1,
  2. Rabia Ergelen2,
  3. Fatma Alibaz-Öner3,
  4. Gülce Çelik3,
  5. Haner Direskeneli3,
  6. Haluk Kazokoğlu4
  1. 1 Department of Ophthalmology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
  2. 2 Department of Radiology, Marmara University School of Medicine, Istanbul, Turkey
  3. 3 Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
  4. 4 Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
  1. Correspondence to Dr Fehim Esen, Department of Ophthalmology, Istanbul Medeniyet University School of Medicine, Istanbul 34000, Turkey; fehimesen{at}yahoo.com

Abstract

Background/aims Takayasu arteritis (TAK) is a chronic granulomatous vasculitis that can lead to ischaemic ocular complications. We aimed to document ocular complications, ocular blood flow and the association of them with systemic clinical findings in TAK.

Material and methods We included 65 patients with TAK (60 female, 5 male, mean age: 41.8±12.9 years) and 30 healthy subjects (30 female, mean age: 39.0±7.5 years) in this study. All of the patients had a detailed rheumatological and ophthalmological evaluation. Ocular blood flow in ophthalmic artery (OA) and central retinal artery (CRA) was evaluated with colour Doppler ultrasonography.

Results Hypertensive retinopathy was observed in 33.9%, and Takayasu retinopathy was observed in 6.2% of patients. Posterior subcapsular cataracts or a history of cataract surgery was seen in 15.4% of the cases. None of the patients experienced visual loss due to ischaemic or neovascular complications. Patients with TAK had increased resistivity index (RI) in ophthalmic artery (0.75 vs 0.66, p=0.002) and CRA (0.75 vs 0.67, p=0.001). Patients with hypertensive retinopathy had significantly longer disease duration (p=0.016). Ophthalmic artery RI was significantly higher in patients with ipsilateral radial artery pulselessness compared with patients without (0.77 vs 0.68, p=0.031).

Conclusion This study reported the lowest prevalence of Takayasu retinopathy and is the only series without permanent visual loss. We documented for the first time that radial artery pulselessness can predict reduction of ipsilateral ocular perfusion. We believe that better management of TAK with current medications reduced ocular complication rates.

  • Retina
  • Diagnostic tests/Investigation
  • Imaging
  • Immunology

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Footnotes

  • Contributors All authors had substantial contributions to the design of the work, the acquisition, analysis and interpretation of data. FE, RE, FA-O and GÇ drafted the work, and HD and HK revised it critically for important intellectual content. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the institutional review board of Marmara University School of Medicine Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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