Vascular occlusions in the eye from cardiac myxomas

Vascular occlusion in the eyes from cardiac myxomas was diagnosed in two cases, belatedly in one and not until after death in the other. Suspicion of a myxomatous origin should be aroused by the combination of unexplained retinal (or choroidal) vascular disease occurring with multifocal neurological symptoms and with systemic symptoms suggesting atypical subacute bacterial endocarditis. The first patient had unilateral retinal artery occlusion by embolic material believed to have been myxomatous. Removal of the cardiac myxoma resulted in disappearance of this material (although the eye remained blind). The second patient who had had evidence of retinal artery occlusion in the clinical course of her multisystemic disease was found at autopsy to have extensive myxomatous involvement of the posterior ciliary arteries and of the choroidal arteries of both eyes and of the retinal artery in one eye.