White thread-like retinal arterioles associated with antiphospholipid antibody syndrome

Report of 2 patients with antiphospholipid antibody syndrome (APS) who had elevated anti-beta2-glycoprotein I antibodies and showed white thread-like retinal arterioles.

A complete ophthalmological examination was conducted on 2 patients who presented with blurred or distorted vision. Fluorescein angiography was used to examine the integrity of the retinal circulatory system. Laboratory blood studies were conducted.

In both patients, some of the major retinal arterioles appeared white and had a thread-like appearance. Fluorescein angiography demonstrated progressive occlusion or stenosis of these major arterioles with extensive insufficiency of the regional capillary bed. Patient 2 had systemic lupus erythematosus and was treated with oral corticosteroid and aspirin. Recanalization occurred during a 3-year follow-up in one of the patients.

APS should be considered in cases of white thread-like retinal arterioles. Occlusion of the retinal arterioles in APS may be progressive and responsible for the chronic hypoxia of the retina.