A case of 17-year-old Japanese girl with Takayasu's disease or arteritis associated with elongated coarctation was reported. In addition to ordinary ophthalmoscopic examination, fluorescein retinal angiography revealed severe ischemia in the eye, suggesting imminent blindness. Aortography disclosed occluded left carotid and subclavian artery, stenosed right innominate artery and elongated coarctation in the descending aorta.
Prosthetic bypass graft between thoracic and abdominal aorta with a branch to the left carotid bifurcation was placed. After surgery ocular manifestations disappeared and pedal arteries regained strong pulsation.
Vascular surgery should be considered in patients with Takayasu's arteritis in whom steroid therapy failed.
Ophthalmoscopical examination is useful in determination of operative indication.
Cerebral blood flow was maintained by systemic hypertension due to coarctation of aorta. Corrective measure in the vessels to the brain should be performed first.