Branch retinal artery occlusion secondary to antiphospholipid syndrome

To demonstrate through a case report a common ocular manifestation of antiphospholipid syndrome (APS). APS is an autoimmune disorder characterized by arterial or venous thrombosis that can affect any organ system. Antibodies associated with the syndrome include anticardiolipin antibodies, lupus anticoagulant, and antibodies directed against beta-2-glycoprotein 1. These molecules all play a role in inhibiting the coagulation cascade, promoting thrombosis, and causing a hypercoagulable state. The most common ocular manifestation is vaso-occlusive retinopathy.

A 54-year-old man presented with complaints of a transient ‘‘fog’’ over the vision in his right eye, lasting 2 to 3 minutes for 6 months. Dilated fundus examination revealed a branch retinal artery occlusion (BRAO) along the superior temporal arcade right eye (OD). Given the patients age, a hematology consult was obtained to rule out hypercoagulable disorders. Laboratory testing confirmed a diagnosis of APS.

Ocular findings can often be the first presenting sign of APS; therefore, it is imperative that primary eye care providers include this disorder in the differential diagnosis of vaso-occlusive disease. This case report reviews APS as the etiology of a BRAO. In addition, common systemic manifestations, ocular manifestations, and treatment and management options for APS are discussed.