Background/Purpose: Ocular involvement in Takayasu arteritis (TAK) mainly arises due to complications related with altered ocular blood flow or side effects of the treatments. In this study, we aimed to document ocular complication rates, ocular blood flow status and the association of ocular blood flow parameters with clinical outcome of the Takayasu arteritis patients followed in a tertiary rheumatology clinic.

Methods: We have included 65 Takayasu arteritis patients followed at Marmara University Medical School, Rheumatology Division (F/M:60/5 , mean age: 41.8 ±12.9 years) and 51 healthy subjects (F/M: 50/1, mean age: 37.4 ±12.9 years) in this study. All of the participants had a detailed ophthalmological examination with optical coherence tomography scan of the macula, retinal nerve fiber layer and choroid. Ocular blood flow in ophthalmic and central retinal arteries was evaluated with Color Doppler ultrasonography. The rheumatology examination data was provided from the last rheumatology visit at which the patients were referred to the ophthalmology clinic.

Results: The most common ocular complication was hypertensive retinopathy (33.9%). Only 4 patients had retinal findings related with Takayasu retinopathy (6.2%). Thirteen eyes had posterior subcapsular cataract (10%) and 7 eyes were pseudophacic (5.4%). None of the patients suffered from a reduction of visual acuity due to ischemic neovascular complications. There was no statistically significant difference between the TAK patients and healthy subjects for the central macular thickness, foveal volume, retinal nerve fiber layer thickness and subfoveal choroideal thickness. TAK patients had an increase of resistivity index in the ophthalmic artery (0.75 vs. 0.66, p=0.002) and central retinal artery (0.75 vs. 0.67, p=0.001). Patients with hypertensive retinopathy had a significantly longer disease duration compared to the group with no retinopathy (7.9 years vs. 4.7 years, p=0.016), while there was no statistically significant difference between the groups for upper extremity blood pressure values. The resistivity index of the ophthalmic artery was higher in patients with ipsilateral radial artery pulselessness compared to the patients who had no pulselessness (0.77 vs. 0.68, p=0.031). The patients with carotid artery bruits did not have a significant change in the ocular blood flow parameters compared to the patients without carotid artery bruits. There was also no significant difference for ocular blood flow parameters between the patients with long  (>5 years) or short disease duration (<5 years).

Conclusion: The prevalence of Takayasu arteritis was lower in our study compared to previous series. However, while none of the patients complained about visual disturbances, Doppler findings indicate a subclinical reduction in ocular blood flow in these patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ocular-findings-and-ocular-blood-flow-changes-in-takayasu-arteritis-a-subclinical-reduction-in-blood-flow-with-a-milder-clinical-course-of-retinopathy/