Left atrial myxoma causing ophthalmic artery occlusion

A 45-year-old Caucasian woman presented with sudden onset right-sided hemiparesis, aphasia and a painful left eye. Examination revealed a bone-white fundus with no perfusion of either the retinal or choroidal circulations. Magnetic resonance imaging showed increased signal density of the left optic nerve sheath, orbital fat and extraocular muscles consistent with infarction of the ophthalmic artery distribution. An echocardiogram disclosed a mobile, multilobulated mass attached to the septal wall of the left atrium. Pathological examination of the resected tumour confirmed the diagnosis of endocardial myxoma. A colour Doppler study performed 1 month after surgery demonstrated absence of flow in the left ophthalmic artery. At 2 months, the left eye had no light perception and an intraocular pressure of 2 mmHg. This clinicopathological report describes the rare presentation of an acute ophthalmic artery obstruction secondary to atrial myxoma.