DR. ADITI BHOSALE

Dr. CHANDANA KAKATI

Abstract

A 32 year old female presented with severe headache, progressive loss of vision both eye with right sided ptosis. On examination there was total ophthalmoplegia right eye and vision 6/18 . In left eye 2nd,3rd and 4rth cranial nerve palsy was present and vision hand movement. Right eye fundus normal and left eye showed optic atrophy. On investigation MRI orbit and other routine examinations are within normal limit. A colour Doppler upper limbs shows reduced caliber of arteries of right upper limb with monophasic flow suggestive of Vasculitis. CT angiography revealed circumferential wall thickening involving right subclavian and right axillary arteries with non visualization of subclavian artery with resultant adjacent collateral formation as described suggesting Takayasu arteritis (type 1). Patient treated with tablet prednisolone 60 mg and methotrexate 10 mg. Ptosis and other ocular signs gradually subsided after 1 month of treatment and currently the patient is under follow up.