Central retinal artery occlusion and infective endocarditis: rigor does matter

Area of Science:

• Ophthalmology
• Cardiology
• Infectious Diseases

Background:

• Infective endocarditis (IE) is a serious infection of the heart valves.
• Central retinal artery occlusion (CRAO) is a rare but devastating ophthalmological emergency.

Observation:

• A patient presented with acute amaurosis (vision loss) as the sole symptom.
• The patient had a history of mitral regurgitation and positive blood cultures for Streptococcus viridans.

Findings:

• Transesophageal ultrasound revealed native valve infective endocarditis.
• CRAO was the presenting manifestation of IE in this afebrile patient.

Implications:

• This case highlights the diverse presentations of infective endocarditis.
• Ophthalmologists and cardiologists must maintain high clinical suspicion for IE in patients with CRAO, even without fever.
• Systematic evaluation is crucial for identifying serious underlying conditions associated with CRAO.