Small vessel involvement in Takayasu's arteritis.
OBJECTIVE
To describe the small retinal and systemic vessel involvement in Takayasu's arteritis.


METHODS
We described 3 patients with Takayasu's arteritis and small retinal vessel occlusion seen in our department between 2004 and 2011. We performed an extensive literature review and provided a global analysis of small retinal vessel involvement in Takayasu arteritis (i.e., total number of patients analyzed=9).


RESULTS
Seven patients had small retinal artery occlusion, and two had venous involvement. Four cases were inaugural of the disease (44.4%). Takayasu's arteritis was extended (Type V) in the majority of patients presenting with small retinal vessel occlusion (5/9, 55.6%), and 8/9 reported cases (88.9%) presented with involvement of the supra-aortic branches. Immunosuppressive regimen allowed an improvement in 5/9 patients and stabilization in 1/9, but the situation worsened in 3/9 patients. The visual outcome was severe, and 3/9 patients (33.3%) experienced irreversible blindness.


CONCLUSIONS
Occlusion of small retinal vessels is a rare and severe microcirculatory complication in Takayasu's arteritis, as well as necrotizing cutaneous vasculitis or myocarditis. Small retinal vessel involvement can be inaugural of the disease and seriously impact the visual prognosis in TA patients.
Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié Salpétrière, Service de Médecine Interne 2, Paris, France.
Nicolas
N
Noel
Nathalie
N
Butel
Phuc
P
Le Hoang
Fabien
F
Koskas
Nathalie
N
Costedoat-Chalumeau
Bertrand
B
Wechsler
Zahir
Z
Amoura
Bahram
B
Bodaghi
Patrice
P
Cacoub
David
D
Saadoun
D000293:Adolescent; D000328:Adult; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D019721:Ophthalmoscopes; D012171:Retinal Vessels / Q000473:pathology*; D013625:Takayasu Arteritis / Q000175:diagnosis*; D055815:Young Adult