Branch Retinal Artery Occlusion Secondary to Antiphospholipid Syndrome

Multiple Successive Branch Retinal Artery Occlusions in a Patient With Antiphospholipid Syndrome Despite Anticoagulation

Purpose: To describe a patient with antiphospholipid syndrome presenting with branch retinal artery occlusions (BRAO) despite anticoagulation. Methods: A single case was evaluated. Results: A 53-year-old woman with antiphospholipid syndrome on anticoagulation presented for a routine ophthalmic examination. She had no visual complaints, and the visual acuity was 20/25-1 OD and 20/30-1 OS. A BRAO was found in the right eye. Despite treatment with aspirin, warfarin, prednisone, plasmapheresis, and rituximab, multiple new occlusions were found when the patient returned the next month. She ultimately had a stroke, which led to her death. Conclusions: This case underscores the importance of interdisciplinary care for patients with antiphospholipid syndrome presenting with BRAOs despite anticoagulation.

Retinal arterial and venous obstruction as the first manifestation of an antiphospholipid antibody syndrome

CASE REPORT

A 34 year-old woman presented with decrease in visual acuity in her right eye (RE). Her past medical history was unremarkable. Dilated fundus examination revealed a central venous occlusion and an obstruction of the cilioretinal artery. Given the patient age, a cardiology and haematology screen was obtained to rule out hypercoagulation disorders and thromboembolic disease. Antiplatelet, anticoagulant, and corticosteroid therapy were started. The laboratory result was positive for anticardiolipin and antiphospholipid antibody. A diagnosis of antiphospholipid syndrome (APS) was made.

DISCUSSION

Antiphospholipid syndrome may cause thrombosis in any organ. The involvement of the retinal vessels may be the first manifestation of this entity. This diagnosis is important to prevent recurrent thrombotic events.

Bilateral Choroidal Occlusion in Antiphospholipid Syndrome Associated with Systemic Lupus Erythematosus

This article reports a rare case of bilateral choroidal occlusion that occurred in a 24-year-old woman with antiphospholipid syndrome (APS) associated with systemic lupus erythematosus (SLE). This young lady concurred with aorta ventralis thrombosis and bilateral iliac artery occlusion when presented, and experienced a rapid deterioration of vision. She also has a history of recurrent miscarriage. Corticosteroid, immunosuppression and anticoagulation therapy were administered. Patients with APS associated with SLE are at risk for thrombotic phenomena, which may affect the ocular vessels of all sizes, including choroidal vessel. Our case alerts ophthalmologists and rheumatologists that bilateral choroidal occlusion may indeed be developed in patients with APS associated with SLE, and is a potential cause of visual morbidity.