Japanese

Branch retinal artery occlusion as the initial manifestation in a case of infectious endocarditis Kosei Tomita 1 , Hiroyuki Kamao 1 , Takaaki Ono 1 , Yoshiaki Ieki 1 , Atsushi Miki 1,2 , Junichi Kiryu 1 1Department of Ophthalmology, Kawasaki Medical School 2Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare pp.839-845
Published Date 2020/7/15
DOI https://doi.org/10.11477/mf.1410213612
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Abstract Purpose:To report a case of infectious endocarditis with branch retinal artery occlusion as the initial clinical manifestation.

Case:A 67-year-old male presented with suddenly impaired upper visual field in the right eye since the previous night.

Findings and Clinical Course:Visual acuity was 0.9 right and 1.0 left. The right eye showed whitening and Roth spot in the upper retinal hemisphere. Optical coherence tomography showed swelling and high intensity in the opaque area. The patient showed signs of systemic inflammation, including fever of unknown origin since 2 months, leukocytosis(13,260 cells/μl), and elevated CRP(3.48 mg/dl). Systemic examination showed infectious endocarditis with mitral insufficiency and verrucae. He was treated by intravenous antibiotics and mitral valve surgery. Vitreous hemorrhage developed 7 days after surgery but disappeared spontaneously. He is doing well for 5 months until present.

Conclusion:This case illustrates that branch retinal artery occlusion may be the initial manifestation of hitherto unsymptomatic infectious endocarditis.


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