Blindness in a pulseless young woman: lessons learned.

Purpose: To report a young woman who presented with blindness secondary to ocular ischemic syndrome (OIS) as the initial presenting feature of Takayasu arteritis (TA).

Design: Case report.

Methods: Computer tomography (CT) aortogram showed severely stenosed aortic branches. Fundus fluorescein angiography showed diffuse capillary nonperfusion.

Results: With conventional medical therapy of initial pulse of intravenous methylprednisolone followed by oral steroids and methotrexate, her headache, fatigued feeling, and inflammatory markers improved. However, the visual recovery remained poor.

Conclusions: OIS in TA may present subacutely and the visual outcome can be poor despite aggressive immunosuppressive therapy.