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Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding
We aimed to describe a case of neovascular glaucoma (NVG) as a first presenting sign of catastrophic antiphospholipid syndrome (CAPS) with heart valve aseptic vegetations known as Libman-Sacks endocarditis. A 39-year-old man was referred for left eye decreased visual acuity and pain, upon examinatio...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339488/ https://www.ncbi.nlm.nih.gov/pubmed/34413759 http://dx.doi.org/10.1159/000516572 |
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author | Grinberg, Anya Midlij, Mohamad Tiosano, Beatrice Shreter, Roni Kesler, Anat |
author_facet | Grinberg, Anya Midlij, Mohamad Tiosano, Beatrice Shreter, Roni Kesler, Anat |
author_sort | Grinberg, Anya |
collection | PubMed |
description | We aimed to describe a case of neovascular glaucoma (NVG) as a first presenting sign of catastrophic antiphospholipid syndrome (CAPS) with heart valve aseptic vegetations known as Libman-Sacks endocarditis. A 39-year-old man was referred for left eye decreased visual acuity and pain, upon examination left eye high intraocular pressure; rubeosis iridis of both eyes (BE); and prominent retinal ischemia. Clinical and fluorescein angiography findings established the diagnosis of left eye NVG with vaso-occlusive disease in BE. Magnetic resonance imaging of the head showed widespread ischemic lesions and hemorrhagic foci. The transesophageal echocardiogram showed 2 big mitral valve lesions consistent with the diagnosis of Libman-Sacks endocarditis. Laboratory and clinical diagnosis of CAPS and suspected SLE was confirmed, and treatment with anticoagulants and IV steroids was initiated. This case demonstrates that severe vaso-occlusive retinopathy with severe brain ischemia should raise the suspicion of systemic autoimmune pro-coagulative diseases with heart valve aseptic vegetations. |
format | Online Article Text |
id | pubmed-8339488 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-83394882021-08-18 Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding Grinberg, Anya Midlij, Mohamad Tiosano, Beatrice Shreter, Roni Kesler, Anat Case Rep Ophthalmol Case Report We aimed to describe a case of neovascular glaucoma (NVG) as a first presenting sign of catastrophic antiphospholipid syndrome (CAPS) with heart valve aseptic vegetations known as Libman-Sacks endocarditis. A 39-year-old man was referred for left eye decreased visual acuity and pain, upon examination left eye high intraocular pressure; rubeosis iridis of both eyes (BE); and prominent retinal ischemia. Clinical and fluorescein angiography findings established the diagnosis of left eye NVG with vaso-occlusive disease in BE. Magnetic resonance imaging of the head showed widespread ischemic lesions and hemorrhagic foci. The transesophageal echocardiogram showed 2 big mitral valve lesions consistent with the diagnosis of Libman-Sacks endocarditis. Laboratory and clinical diagnosis of CAPS and suspected SLE was confirmed, and treatment with anticoagulants and IV steroids was initiated. This case demonstrates that severe vaso-occlusive retinopathy with severe brain ischemia should raise the suspicion of systemic autoimmune pro-coagulative diseases with heart valve aseptic vegetations. S. Karger AG 2021-07-20 /pmc/articles/PMC8339488/ /pubmed/34413759 http://dx.doi.org/10.1159/000516572 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Case Report Grinberg, Anya Midlij, Mohamad Tiosano, Beatrice Shreter, Roni Kesler, Anat Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title | Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title_full | Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title_fullStr | Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title_full_unstemmed | Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title_short | Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding |
title_sort | neovascular glaucoma as a presenting sign of catastrophic antiphospholipid syndrome with a “catastrophic” heart valve finding |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339488/ https://www.ncbi.nlm.nih.gov/pubmed/34413759 http://dx.doi.org/10.1159/000516572 |
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