Cattle trucking in Takayasu retinopathy

Abstract Takayasu arteritis is a rare chronic inflammatory disease of the aorta and its branches that can lead to ocular complications due to impaired blood flow. Takayasu retinopathy represents hypoperfusion-related retinal changes and may present with characteristic angiographic findings. We report a 20-year-old Asian woman with recently diagnosed Takayasu arteritis referred for ophthalmic evaluation. Her best-corrected visual acuity was 20/40 in both eyes, with normal anterior segment findings. Fundus examination showed peripheral microaneurysms bilaterally. Fundus fluorescein angiography revealed delayed arm-to-retina time (16 seconds), sluggish circulation, and segmental blood flow producing a cattle-trucking (box-carring) appearance, along with diffuse late leakage. A diagnosis of Stage 2 Takayasu retinopathy was made. The patient was started on immunosuppressive therapy and referred for endovascular intervention. Early recognition of ischemic signs like cattle-trucking is essential to prevent vision loss.