First Author: J.Ortega Molina SPAIN
Co Author(s): A. Solans Perez de Larraya M. Gonzalez Gallardo
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Macular branch retinal artery occlusion due to infective endocarditis (IE) is a rare disease, scarcely described in literature. It can occur despite receiving systemic antibiotic treatment.
Department of Ophthalmology, San Agustin Hospital, Linares (Jaén), Spain. Department of Ophtalmology, University of Granada Hospital Complex, Granada, Spain.
Observational case report.
A 56-year-old man presented with acute amaurosis in his left eye (OS) associated with temperature and malaise. He was under antibiotic treatment for a urinary infection secondary to phimosis. Ophthalmologist exploration revealed: Visual acuity in his right eye (OD)=1 and amaurosis in his OS. Fundoscopy examination showed yellowish-white retinal foci around the macula in his OD and cherry red spot in his OS. The patient was suspected of having a systemic infection with septic emboli in both eyes. Clinical evaluation was completed by an internist with diagnosis of IE. The patient underwent heart surgery with mitral valve replacement. The microbiologist culture of the valve revealed an infection due to aerococcus urinae. All blood tests performed presented normal ranges. The patient has been monitorized from the time of referral to the present day. Fluorescein angiography revealed macular ischaemia in his OS without ischaemic foci in his OD. Visual fields (VF) showed a total central loss of sensitivity in his OS and a superonasal defect in his OD. An improvement in VF has been observed in recent check-ups in his OD.
IE has many different forms of presentation and a high clinical suspicion is often required to reach the diagnosis. Macular branch retinal artery occlusion due to IE is rare and the prognosis for vision is poor.