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Case Report: Recurrent Transient Monocular Vision Loss Secondary to Protein C Deficiency.

Tina Zeng, Kelly A Malloy¹

¹Department of Neuro-Ophthalmic Disease, Pennsylvania College of Optometry, Salus University, Philadelphia, Pennsylvania.

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|December 19, 2021

Summary

Protein C deficiency can cause transient monocular vision loss (TMVL) and stroke. Early diagnosis through hypercoagulable state testing is crucial for preventing vision loss and stroke.

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Area of Science:

Ophthalmology
Neurology
Hematology

Background:

Protein C deficiency is a thrombophilic condition linked to venous and arterial thrombi.
Transient monocular vision loss (TMVL) can be an arterial thrombotic event, potentially indicating underlying hypercoagulable states.

Observation:

A 59-year-old woman experienced recurrent TMVL, followed by an ischemic stroke.
Initial extensive workup for stroke was unrevealing, prompting further investigation for hypercoagulable conditions.

Findings:

The patient was diagnosed with protein C deficiency, a condition previously unknown in her personal or family history.
This diagnosis led to the initiation of oral anticoagulants for stroke prophylaxis.

Implications:

Recurrent TMVL warrants investigation for hypercoagulable states, even without a prior history of venous thromboembolism.
Ophthalmologists play a key role in identifying patients with hypercoagulable conditions, facilitating early diagnosis and stroke prevention.