Fluorescein and OCT Angiography Features of Takayasu Disease

Chotard, Géraldine; Diwo, É.; Coscas, Florence; Butel, Nathalie; Saadoun, David; Bodaghi, Bahram

doi:10.1080/09273948.2018.1455876

Cited by 12 publications

(13 citation statements)

References 15 publications

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“…However, the theory has been recently challenged with the advent of OCTA. Chotard et al (22) analyzed 14 eyes of 7 patients with TA who underwent OCTA. A significant correlation was described between foveal avascular zone enlargement on OCTA and decreased BCVA.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular prognosis varies between individual studies, in part due to different study populations and perioperative management. Although most previous studies have exclusively used fundus fluorescein angiography (FFA) for followup surveillance in TA, few studies looked at retinal perfusion in the macula, especially with the advent of optical coherence tomography (OCT) angiography (OCTA) (21,22). A detailed summary of existing data is therefore necessary to clarify surgical outcomes in this particular cohort.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Zeng

Duan

et al. 2022

Front. Immunol.

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BackgroundTakayasu’s arteritis (TA) is a rare, chronic granulomatous large-vessel vasculitis that can lead to ocular ischemia. Ocular outcomes after therapeutic management in TA remain largely unknown. We herein conduct a case-based systematic review to address the current treatment options in this particular cohort.MethodsPubMed, Medline, and EMBASE databases were searched pertaining to ocular outcomes after systemic treatment in TA. Studies reporting ocular examinations before and after treatment in TA patients with ocular ischemia were included. Clinical characteristics, therapies, ocular outcomes, and complications were recorded.ResultsA 29-year-old woman with newly diagnosed TA showed dramatic regression of Takayasu’s retinopathy (TR) following balloon angioplasty. Optical coherence tomography angiography (OCTA) was used as a novel strategy for subsequent follow-up. A total of 117 eyes of 66 patients with a median age of 27 years were included for systematic review. TR was the most common ocular manifestation. Oral steroids were prescribed in nearly all patients (n = 65), followed by the use of methotrexate and antiplatelet therapy. Of the patients, 65.8% and 34.2% underwent open surgery and endovascular procedure, respectively. The median follow-up period was 12 weeks (interquartile range 8–33.5). Surgical therapy showed better ocular improvement (including visual and imaging responses) in both acute and chronic vision loss, along with fewer complications than medical therapy alone. In the surgical group, the visual prognosis was significantly better in patients with initial visual acuity better than 20/200 (p = 0.03) and those who underwent surgery before stage III TR (p = 0.01). Ocular outcomes were equivalent in the two surgical approaches.ConclusionClinicians should be familiar with ophthalmic manifestations of this potentially treatable complication in TA. Compared with medical therapy alone, surgical intervention might be a better choice for both acute and chronic vision loss. Surgery is best recommended before the onset of irreversible ischemia to the globe. A combined regimen (oral steroids, immunosuppressants, and antiplatelet drugs) might be effective for those with surgical contradictions or reluctance to an invasive procedure. Physicians should be aware of the importance of ocular examinations, including OCTA, during the diagnosis and follow-up in TA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Zeng

Duan

et al. 2022

Front. Immunol.

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“…The strict analysis of the posterior pole in our cases found microaneurysms in only 22% of eyes, which is a value that is close to previous results. For example, Chotard et al [ 11 ] have detected microaneurysms in five out of 26 eyes using OCTA. Microaneurysms were detected in up to 94.4% of cases when the peripheral fields were assessed, showing the value of UWF imaging to detect ocular manifestations of TA, which appeared to be more frequent than usually assumed [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Ultra-Wide-Field Retinal Imaging Findings and Vascular Supra-Aortic Changes in Takayasu Arteritis

Poignet

Bonnin

Gaudric

et al. 2021

JCM

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(1) Background: Takayasu arteritis (TA) is a chronic inflammatory large-vessel vasculitis. Ultra-wide-field imaging allows describing the retinal lesions in these patients and correlating them with vascular supra-aortic stenosis. (2) Methods: In total, 54 eyes of 27 patients diagnosed with TA were included, and a complete ophthalmological examination was performed, including UWF color fundus photography (UWF-CFP), fluorescein angiography (UWF-FA), and computed tomography angiography measuring supra-aortic stenosis. Eleven patients underwent Doppler ultrasound imaging assessing the blood flow velocity (BFV) in the central retinal artery (CRA). (3) Results: Microaneurysms were detected in 18.5% of eyes on fundus examination, in 24.4% of eyes on UWF-CFP, and in 94.4% of eyes on UWF-FA. The number of microaneurysms significantly correlated with the presence of an ipsilateral supra-aortic stenosis (p = 0.026), the presence of hypertension (p = 0.0011), and the duration of the disease (p = 0.007). The number of microaneurysms per eye negatively correlated with the BFV in the CRA (r = −0.61; p = 0.003). (4) Conclusions: UWF-FA improved the assessment of TA-associated retinal findings. The significant correlation between the number of microaneurysms and the BFV in the CRA gives new insight to our understanding of Takayasu retinopathy. The total number of microaneurysms could be used as an interesting prognostic factor for TA.

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“…Visit casereports.bmj.com for more articles like this and to become a Fellow a final diagnosis of bilateral stage 4 Takayasu retinopathy with anterior ischaemic optic neuropathy and ocular ischaemic syndrome was made. [1][2][3] Panretinal photocoagulation was done in both eyes and subsequently she underwent bilateral carotid endarterectomy for carotid artery occlusion. At 2-month follow-up, IOP in both eyes was 14 mm Hg and her BCVA had improved to 20/40 and 20/60 in right and left eyes, respectively.…”

Section: Customer Servicementioning

confidence: 99%

Multimodal imaging in bilateral ocular ischaemic syndrome with anterior ischaemic optic neuropathy in a case of Takayasu arteritis

et al. 2020

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Fluorescein and OCT Angiography Features of Takayasu Disease

Cited by 12 publications

References 15 publications

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Therapeutic Management of Ocular Ischemia in Takayasu’s Arteritis: A Case-Based Systematic Review

Correlation between Ultra-Wide-Field Retinal Imaging Findings and Vascular Supra-Aortic Changes in Takayasu Arteritis

Multimodal imaging in bilateral ocular ischaemic syndrome with anterior ischaemic optic neuropathy in a case of Takayasu arteritis

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