A case of anti-VEGF therapy application in Takayasu arteries with retinopathy

Am J Ophthalmol Case Rep. 2020 Apr 29:19:100706. doi: 10.1016/j.ajoc.2020.100706. eCollection 2020 Sep.

Abstract

Purpose: Takayasu arteritis (TA) is a systemic granulomatous large vessel vasculitis that involves mainly the aorta and its primary branches, and occurs most commonly in young females. Ocular manifestations of TA include small vessels dilation, microaneurysm, arteriovenous anastomosis, retinal ischemia and retinopathy. However, no specific and effective treatments for Takayasu retinopathy is applied. This case aimed to demonstrate the role of anti-VEGF (vascular endothelial growth factor) therapy in treating Takayasu retinopathy.

Observations: We herein reported an 18-year-old Asian woman who presented with typical wreath-like arteriovenous anastomosis around the disc in the right eye and vitreous hemorrhage in the left eye. The stenosis and occlusion of bilateral subclavian arteries, carotid arteries and other proximal arteries on angiography confirmed the diagnosis of TA. Meanwhile, elevated ESR and CRP revealed that TA was in the active stage. We applied anti-VEGF therapy in treating Takayasu retinopathy specially to inhibit neovascularization. Additionally, vitreous extraction was conducted in the left eye after the treatment of anti-VEGF therapy.

Conclusions and importance: This is the first report of effective application of anti-VEGF therapy in inhibiting wreath-like arteriovenous anastomosis and improving vitrectomy in TA.

Keywords: AMD, age-related macular degeneration; Anti-VEGF; Arteriovenous anastomosis; CMV, cytomegalovirus; CRP, C-reactive protein concentration; CRVO, central retinal vein occlusion; DME, diabetic macular edema; ESR, erythrocyte sedimentation rate; FFA, Fundus fluorescein angiography; HSV 1, herpes simplex virus 1; Neovascularization; OCT-A, Optical coherence tomography angiography; TA, Takayasu arteritis; TR, Takayasu retinopathy; Takayasu arteritis; Takayasu retinopathy; VEGF, Vascular endothelial growth factor.

Publication types

  • Case Reports