POS0697 OPHTHALMIC MANIFESTATIONS IN TAKAYASU ARTERITIS PATIENTS: A CROSS-SECTIONAL MONOCENTRIC STUDY
Authors: C. Piccolo, C. Campochiaro, A. Tomelleri, M. Menean, E. Baldissera, F. Bandello, E. Miserocchi, L. Dagna
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Takayasu arteritis (TA) is a chronic large-vessel vasculitis affecting the aorta and its branches [1]. TA can cause chronic ischemia in various territories, including the eyes. The most significant ocular manifestation is Takayasu retinopathy (TR) [2], characterized by small vessel dilation, microaneurysm formation and arteriovenous anastomosis. Ischemic ocular symptoms mainly result from carotid artery stenosis or occlusion, and hypertensive retinopathy can arise secondary to renal artery stenosis. <h3>Objectives:</h3> A comprehensive evaluation of TA's ocular manifestations is though still lacking. Here, we aimed to thoroughly evaluate eye involvement in TA patients and investigate the relationship between disease characteristics and ocular manifestations. <h3>Methods:</h3> Consecutive TA patients fulfilling the 2022 ACR/EULAR criteria and sex- and age-matched healthy controls (HCs) were included. TA patients and HCs underwent a comprehensive ophthalmic examination including visual acuity, indirect fundoscopy and multimodal imaging. Data on medical and ocular history, and disease features were collected. First, a comparison of central foveal avascular zone (FAZ) area, superficial (SCP) and deep capillary plexus (DCP) vessel density and choriocapillaris flow deficit density between TA and control eyes was performed. Second, the association between retinal vascular metrics and clinical parameters in TA patients using linear mixed models was evaluated. <h3>Results:</h3> 106 eyes from 53 TA patients (47 females, mean age ±15 years) and 53 HCs were included. No retinal vasculitis or TR was observed in TA patients. Notable findings included increased outer plexiform layer thickness and subfoveal choroidal thickness in TA patients compared to controls. In TA patients the FAZ area was significantly increased (0.38±0.19 vs.30±0.11 mm2, p=0.049), while the vessel density of the SCP was significantly lower (35.09±2.98% vs 36.75±2.43%, p=0.002) compared to HCs. Furthermore, higher FAZ area values were associated with arthritis, dizziness, and headache in TA patients (see Table 1). Lower SCP vessel densities correlated with carotid artery involvement and claudication of extremities, while lower DCP vessel densities were associated with fever at the time of diagnosis. Additionally, patients with a higher baseline ACR/EULAR 2022 cumulative score exhibited lower SCP vessel densities. <h3>Conclusion:</h3> Ocular vascular abnormalities with increased FAZ area and reduced vessel density of the SCP can be detected in TA patients even without TR. Chronic ischemia secondary to carotid involvement seems to be a major driver for eye involvement. <h3>REFERENCES:</h3> [1] Grayson, P. C., et al. (2022). 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Annals of the Rheumatic Diseases, 81(12), 1654-1660. [2] Peter, J., et al. (2010). Hypoperfusive and hypertensive ocular manifestations in Takayasu arteritis. Clinical Ophthalmology, 4, 1173-1176. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>