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Multimodality Diagnosis of Mesenteric Ischemia
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MULTIPLE ORGAN DYSFUNCTION SYNDROME AND DISSEMINATED INTRAVASCULAR COAGULATION CAUSING EXTENSIVE MULTIPLE AMALRIC
Ivan J Lee1, Jose S Pulido2, Carl D Regillo2
1West Virginia University Eye Institute, Morgantown, West Virginia; and.
Retinal Cases & Brief Reports
|February 2, 2023
Summary
Disseminated intravascular coagulation can cause extensive bilateral choroidal infarctions, a rare complication of multiple organ dysfunction syndrome. This case highlights the ocular manifestations of severe systemic illness.
Area of Science:
- Ophthalmology
- Critical Care Medicine
- Hematology
Background:
- Multiple organ dysfunction syndrome (MODS) and disseminated intravascular coagulation (DIC) are severe systemic conditions.
- Ocular complications, particularly choroidal infarctions, are rare but significant manifestations of these critical illnesses.
Observation:
- A 49-year-old female presented with vision loss after a drug overdose, complicated by MODS and DIC.
- Ophthalmic examination revealed bilateral choroidal infarcts, characterized by hemorrhages, cotton wool spots, and pigmentary changes.
Findings:
- Fundus photography and fluorescein angiography confirmed extensive bilateral choroidal infarctions.
- Optical coherence tomography showed choroidal thinning and retinal pigment epithelium atrophy.
- Visual field deficits correlated with the areas of infarction, resulting in reduced visual acuity.
Implications:
- This case underscores the association between DIC and choroidal infarctions, presenting as the Amalric choroidal triangular sign.
- Early recognition of these ocular findings is crucial for managing patients with severe systemic disease.
- Further research is needed to understand the pathophysiology and optimize treatment for DIC-induced choroidal infarctions.
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