Severe vaso-occlusive chorioretinopathy in a patient with catastrophic antiphospholipid antibody syndrome secondary to systemic lupus erythematosus

Drimbea, A.; Crețu, Ioana; Jany, B; Milazzo, Stephen C.

doi:10.1016/j.jfo.2014.05.024

Cited by 3 publications

(4 citation statements)

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“…1 This pathology ought to be distinguished from antiphospholipid antibody syndrome (APS) by its acute onset and small vessels involvement. It may be primary, or secondary to underlying disorders, most frequently systemic lupus erythematosus (SLE), 2 rheumatoid arthritis or other rheumatologic diseases. 1 Surgery, pregnancy, post-partum, trauma, infection, oral contraceptive medication or anti-coagulation withdrawal are the most identified trigger factors.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal involvement in patients with catastrophic anti-phospholipid syndrome: Two case reports

Zaafrane

Fendouli

Abdesslem

et al. 2023

European Journal of Ophthalmology

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Purpose To describe choroidal involvement in catastrophic antiphospholipid syndrome (CAPS). Methods We report here two cases of bilateral CAPS choroidopathy in two female patients. Results Case report 1: A thirty-five-year-old female patient, with history of primary anti-phospholipid syndrome (APS), treated with anticoagulants, presented an acute renal failure following a salpingectomy. She complained of bilateral acute blurred vision. Ophthalmologic evaluation revealed visual acuity (VA) of 5/10, extensive serous retinal (SRD) detachment, areas of hypofluorescence on fluorescein angiography (FA), and non-perfusion areas in the choriocapillaris, on optical coherence tomography angiography (OCT-A), in both eyes. Considering the diagnosis of probable CAPS, the patient received intravenous pulse steroids, plasmapheresis, intravenous anticoagulation and haemodialysis, with favourable evolution. Case report 2: A thirty-three-year-old female patient, with history of systemic lupus erythematosus (SLE) and secondary APS, treated with corticosteroids, immunosuppressive agents and anti-coagulation, presented a myocardiac infarction. She complained of bilateral acute blurred vision. Ophthalmologic evaluation revealed VA of 1/10 in the RE and 6/10 in LE, bilateral extensive SRD, leakage points on FA and non-perfusion areas in the choriocapillaris on OCT-A. Criteria of probable CAPS were fulfilled. Treatment with intravenous pulse steroids, anticoagulation and reanimation modalities allowed VA improvement. Alveolar haemorrhage and cardiogenic shock led to fatal evolution. Conclusion Our case reports highlight the importance of early diagnosis and ophthalmic evaluation in CAPS. Multidisciplinary approach and rapid initiation of effective treatment, based on corticosteroids, anticoagulation and plasmapheresis, allow better vital and visual prognosis.

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Section: Introductionmentioning

confidence: 99%

“…This pathology ought to be distinguished from antiphospholipid antibody syndrome (APS) by its acute onset and small vessels involvement. It may be primary, or secondary to underlying disorders, most frequently systemic lupus erythematosus (SLE), 2 rheumatoid arthritis or other rheumatologic diseases. 1…”

Section: Introductionmentioning

confidence: 99%

Choroidal involvement in patients with catastrophic anti-phospholipid syndrome: Two case reports

Zaafrane

Fendouli

Abdesslem

et al. 2023

European Journal of Ophthalmology

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“…2 The last publication from the international registry with information on ophthalmic manifestations dates from 2009; it reported retinal involvement in 7% of cases but did not provide a detailed description of the ophthalmologic prognosis. [3][4][5][6][7][8][9][10][11][12][13][14] The aim of our study was to describe the posterior ophthalmic findings of a consecutive case series of patients with CAPS and to compare our findings with the most recent data from the 500 patients included in the international CAPS Registry. 15…”

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confidence: 99%

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confidence: 99%

Catastrophic Antiphospholipid Syndrome and Posterior Ocular Involvement

Morel

Bonnet

Mehawej

et al. 2021

Retina

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Purpose: To describe the posterior ophthalmic manifestations of catastrophic antiphospholipid syndrome.Methods: Retrospective case series of patients presenting with catastrophic antiphospholipid syndrome and posterior segment ocular manifestations. The main outcomes were the type of posterior segment manifestations at catastrophic antiphospholipid syndrome diagnosis, specifically retinal vascular occlusion, vasculitis, or choroidopathy, and the final best-corrected visual acuity.Results: This study included 23 patients (11 cases treated by the authors and 12 published case reports); 21 (91%) of them female. Their median age at diagnosis was 28 years (range, 16-79 years). Ophthalmologic manifestations were usually bilateral (n = 19, 83%) and involved vascular occlusive retinopathy (n = 17, 74%), choroidopathy (n = 11, 48%), or retinal vasculitis (n = 1, 4%). Final best-corrected visual acuity was not significantly worse than the bestcorrected visual acuity at diagnosis (P = 0.16). Retinal vascular occlusions were associated with poorer final visual acuity than choroidopathy (P = 0.002). After a median follow-up of 14 months (range, 2-132 months), nearly half the patients (n = 11, 48%) had permanent vision loss including best-corrected visual acuity of ,20/400 for 4 patients.Conclusion: Posterior ophthalmic manifestations of catastrophic antiphospholipid syndrome were mainly bilateral retinal vascular occlusion, which had the worst visual prognosis, followed by choroidopathy and retinal vasculitis. Permanent visual loss was common.

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French National Diagnostic and Care Protocol for antiphospholipid syndrome in adults and children

Amoura,

Bader-Meunier,

BAL dit Sollier

et al. 2023

La Revue de Médecine Interne

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Severe vaso-occlusive chorioretinopathy in a patient with catastrophic antiphospholipid antibody syndrome secondary to systemic lupus erythematosus

Cited by 3 publications

References 10 publications

Choroidal involvement in patients with catastrophic anti-phospholipid syndrome: Two case reports

Choroidal involvement in patients with catastrophic anti-phospholipid syndrome: Two case reports

Catastrophic Antiphospholipid Syndrome and Posterior Ocular Involvement

French National Diagnostic and Care Protocol for antiphospholipid syndrome in adults and children

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