9 Regression of vascular stenotic lesions has been reported in steroid-treated TA patients. 17 Cytotoxic drug therapy, usually with methotrexate, is required as a supplement to steroids for control of disease activity in nearly half of the patients. Photograph of right ocular fundus, ten days after patient suffered monocular blindness, showing residual cherry red spot at macula, edema of retina, pallor and blurred margin of optic disc. Since thrombosis in situ is uncommmon in TA, the use of anticoagulation is not standard practice. However, morbidity from strokes, blindness and heart failure may be severe.
Sudden death can result from myocardial infarction, aneurysmal rupture or aortic dissection.
A high index of suspicion is therefore required for the diagnosis of TA at the presymptomatic phase 1 stage, when treatment may induce remission and complications may be avoided or minimized. References Ishikawa K. Takayasu's disease. 3 rd edition. Oxford textbook of medicine. Takayasu M. A case of peculiar changes in the central retinal vessels.