Simultaneous Branch Retinal Artery and Vein Occlusion as the Presentation of Antiphospholipid Syndrome
Purpose
To report a case of antiphospholipid Syndrome (APS)
Methods
Interventional case report
Results
A 29-year-old male without any past history complained of blurred vision OS for one day. His BCVA was 20/20 OU. OCT showed para-foveal edema OS. FA revealed intraretinal hemorrhage and delay in filling of the retinal artery and vein. Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) were diagnosed OS. His right eye was relative normal. Because of the diagnosis of young stroke, he was referred to cardiologist and rheumatologist. The lab data showed negative finding except positive lupus anticoagulant. Cardiac echo, carotid phonoangiography, and brain MRI were normal. Under the impression of APS, he was admitted for heparin treatment and his vision regained after one month.
Conclusion
The classic manifestations of APS are thrombosis and obstetric complications. Ocular involvement ranges from anterior and posterior segment manifestations to neuro-ophthalmologic features. The most common ocular manifestation is retinal vascular occlusion. APS should be pursued for unexplained retinal arterial and venous thrombosis. Carotid Doppler ultrasound and the transesophageal echocardiography should be arranged to identify an embolic source. Thrombophilic work-up may include lupus anticoagulant, anti-cardiolipin, anti-b2-glycoprotein I, homocysteine, protein C, protein S, plasminogen anti-thrombin levels, activated protein C resistance and the Factor V Leiden mutation. Prompt referral to a rheumatologist or hematologist for systemic treatment may prevent further morbidity.
Conflict of interest
No
Author 1
Last name
LIN
Initials of first name(s)
CJ
Department
Ophthalmology, China Medical University Hospital; Department of Optometry, Asia Uni
City
Taichung
Country
Taiwan
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