Ocular involvement in Takayasu arteritis – A case series from a tertiary eye center in South India

PURPOSE: To analyze the clinical profile of patients with Takayasu arteritis (TAK) from a South Indian patient population who presented to a tertiary referral eye center. METHODS: Retrospective case series between 2016 and 2025. RESULTS: Of the 13 cases of TAK, 11 were females and 2 were males (female: male = 11:2). The mean age was 31.92 ± 7.04 years. Nine cases initially presented to an ophthalmologist. The most common presenting symptoms were eye pain (eight cases) and diminution of vision (seven cases), of whom two had sudden vision loss. Ocular involvement included ocular ischemia with retinal vessel spasm and constriction (three cases), Takayasu retinopathy (three cases), and central retinal artery occlusion (one case). Optic disc pallor, dilated conjunctival and episcleral vessels, scleritis, hypertensive retinopathy, and atypical Tolosa Hunt syndrome were other presentations. Presumed ocular tuberculosis in two cases led to an incidental diagnosis of TAK. Based on the imaging findings, six cases had type I TAK, five cases had type V TAK, and one case each had type IV and type IIa TAK. Treatment included systemic corticosteroids and conventional disease-modifying antirheumatic drugs (methotrexate and mycophenolate mofetil) and tocilizumab. Good visual outcome on early treatment was seen in our series. CONCLUSION: TAK is an important and underrecognized cause of ocular inflammation and ischemia in young patients. Our series highlights that ocular involvement can precede systemic diagnosis. Early diagnosis and treatment results in a good visual outcome.