Sudden visual loss after cardiac resynchronization therapy device implantation.

Area of Science:

• Ophthalmology
• Cardiology
• Neurology

Background:

• Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
• Complications following CRT device implantation can occur, though visual disturbances are rare.

Observation:

• A 62-year-old man experienced sudden monocular vision loss after CRT implantation.
• Ophthalmologic examination revealed Roth spots and delayed retinal perfusion on fluorescein angiography.
• The patient later suffered an ischemic stroke following a temporal artery biopsy.

Findings:

• The visual acuity loss was attributed to a possible cardiogenic embolism, potentially from undiagnosed infective endocarditis.
• Despite inflammatory signs improving on angiography, visual acuity did not recover.
• The mechanism of severe visual damage without significant retinal anatomical alteration remains unclear.

Implications:

• This case suggests a potential link between CRT, infective endocarditis, and embolic events causing vision loss.
• Further investigation into embolic phenomena following CRT is warranted.
• Ophthalmologists and cardiologists should consider embolic causes in patients presenting with vision loss post-CRT.