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Primary antiphospholipid syndrome presenting with homonymous quadrantanopsia
Hee Kyung Yang1, Ki Won Moon2, Min Jung Ji3
1Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
American Journal of Ophthalmology Case Reports
|March 20, 2018
Summary
Primary antiphospholipid syndrome can cause isolated homonymous quadrantanopsia, a visual field defect. This case highlights the importance of considering this condition in patients with multiple cerebral infarcts and visual disturbances.
Area of Science:
- Neurology
- Ophthalmology
- Rheumatology
Background:
- Primary antiphospholipid syndrome (APS) is an autoimmune disorder characterized by recurrent thrombotic events or pregnancy complications.
- Cerebrovascular manifestations are common in APS, but isolated visual field defects are rare.
Observation:
- A 50-year-old man presented with a month of visual disturbance.
- Visual field testing revealed a right homonymous superior quadrantanopsia.
- Brain MRI showed an old infarct in the left occipital lobe and other cerebral lesions.
Findings:
- Laboratory tests revealed elevated serum anti-β2 glycoprotein I antibody levels, persisting for over 12 weeks.
- The patient was diagnosed with primary antiphospholipid syndrome.
- Anticoagulation therapy was initiated.
Implications:
- This is the first reported case of primary APS presenting with isolated homonymous quadrantanopsia.
- Antiphospholipid syndrome should be considered in the differential diagnosis of patients with homonymous visual field defects and multiple cerebral infarcts.
- Early diagnosis and treatment of APS can prevent further thrombotic events and neurological damage.
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