First Author: V.Baskaran INDIA
Co Author(s): P. Sen
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To report a rare case of ophthalmic artery occlusion with atrial myxoma in a community based tertiary ophthalmic centre.
Community based teaching tertiary eye care centre, South India
Single case report of a South Asian female presented to our institute. Reported due to rarity of the condition and varying presentation.
A sixty year old female presented with sudden painless diminision of vision in left eye since three days. No other specific ophthalmic or medical history. Her visual acuity was perception of light with grade 2 relative afferent pupillary defect in left eye. Rest of the anterior segment evaluation was normal. Dilated fundus examination revealed mild hyperaemia of disc, pale and oedematous retina, cattle trucking of blood columns in arterioles and absence of cherry red spot. Fundus flourescein angiography (FFA) showed delayed arm retina time with patchy choroidal hyperflourescence with choroidal infarcts and delayed arteriovenous transit time with boxcarring of arterioles suggestive of ophthalmic artery occlusion. Blood investigations and carotid Doppler were normal. Electrocardiogram showed large left atrial myxoma attached to interatrial septum with mild tricuspid regurgitation. The patient was immediately referred to cardiologist for further management.
Atrial myxomas can cause retinal vessel embolism. Atrial Myxoma is a true intracardiac neoplasm and is the most common form of primary cardiac tumour with excellent prognosis on excision. They have been implicated in the pathogenesis of both isolated retinal and choroidal infarctions. The presence of embolic phenomenon such as ophthalmic artery occlusion even in the absence of electrocardiographic or auscultation abnormalities should prompt electrocardiography and neuroimaging if required. Detailed medical history and meticulous workup to identify cause of vessel occlusion can be lifesaving.