Ocular and Neurologic Manifestations of Takayasu Arteritis


ABSTRACT

Takayasu arteritis is a rare chronic inflammatory arteritis asssociated with ocular and neurologic manifestations. 2 case reports of patients with angiographic diagnosis of Takayasu’s arteritis are presented.

Case 1:

Miss ZS is a 21 year old black female who presented with headaches, syncope and aphasia. She showed signs of bilateral ocular ischaemic syndrome, Takayasu’s retinopathy, steroid induced cartaracts and right sided paralysis.

Management included ophthalmic examination, systemic examination, blood tests, lumbar puncture, chest x-ray, Echocardiogram, CT-scan of the brain. Further test included magnetic resonance imaging and fluoresceien angiogram. The steroid induced cataracts were removed surgically and neovascularisation of the retina was treated with panretinal photocoagulation. Patient was treated together with rhematologists, cardiologists, physicians and ophthamologists. Patient presently on Methotrexate, Asprin as well as steroids.

Case 2:

Miss CM is a 24 year old black female who presented with headache, sudden loss of vision of her left eye and aphasia. She had signs of a left ophthalmic artery occlusion, Takayasu’s retinopathy and resolving cerebrovascular accident.

Management included ophthalmic examination, systemic examination, blood tests, lumbar puncture, chest x-ray, echocardiogram, CT-scan of the brain. Further test included magnetic resonance imaging and fluoresceien angiogram. Patients was treated together with rheumatologists, cardiologists, neurologists and ophthalmologists. Patient was treated with Methotrexate, Asprin and Oral steroids.

Lessons Learnt:

Takayasu arteritis can present with systemic and ocular signs of ischaemia

Life threatening signs can be picked up on imaging and other investigations

Multidisciplinary approach is required. Medical treatment (disease modifying drugs) can alter the course of the disease. Surgical intervention may be required.

Inspite secondary procedues and treatment, Takayasu’s Arteritis can progress and cause loss of vision and loss of the eye.


CONTACT DETAILS

 

Darshana Soma
University of Pretoria (Steve Biko Academic Hospital)
South Africa
Email : Darshana.soma@gmail.com
Work Phone: +0027824892820