Bilateral Macular Infarction in Primary Antiphospholipid Syndrome.

Kim, Hyun Ju; Yoon, Han Gyul; Kim, Seong Taeck

doi:2017.58.10.1205

J Korean Ophthalmol Soc > Volume 58(10); 2017 > Article

Case Report

Journal of the Korean Ophthalmological Society 2017;58(10):1205-1210.
DOI: https://doi.org/10.3341/jkos.2017.58.10.1205 Published online October 15, 2017.

Bilateral Macular Infarction in Primary Antiphospholipid Syndrome.

Hyun Ju Kim, Han Gyul Yoon, Seong Taeck Kim

Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea. s20age@hanmail.net

원발항인지질항체 증후군에서 발생한 양안 황반부 경색 1예

김현주⋅윤한결⋅김성택

조선대학교 의학전문대학원 안과학교실

Correspondence: Seong Taeck Kim,
Email: s20age@hanmail.net

Received: 1 June 2017 • Revised: 30 August 2017 • Accepted: 24 September 2017

Abstract

PURPOSE
We report a rare case of bilateral macular infarction as an ocular presenting sign of primary antiphospholipid syndrome. CASE SUMMARY: A 29-year-old woman who had undergone a cesarean section for chorioamnionitis in the department of Obsterics was referred to the department of ophthalmology for bilateral visual loss. At examination, best-corrected visual acuity (BCVA) of the right eye was counting fingers, and for the left was 0.05. Fundus examination revealed extensive macular edema and cotton-wool spots in both eyes. We performed hematologic tests including thrombophilia examination. Antinuclear antibody and rheumatoid factor were negative but lupus anticoagulant presented high titers on two occasions 12 weeks apart. She was administered sub-Tenon's injections of triamcinolone acetonide 50 mg/week in both eyes under the diagnosis of bilateral macular arteriolar occlusion in primary antiphospholipid syndrome. Her BCVA remained 0.025 in her right eye and improved to 0.125 in her left eye. CONCLUSIONS: Macular infarction is an uncommon but severe complication of antiphospholipid syndrome. Early and regular fundus exam in patients with antiphospholipid syndrome is necessary to avoid progression of severe ocular complications.

Key Words: Antiphospholipid syndrome;Macular infarction