Abstract
A 22-year-old woman presenting with recurrent transient episodes of vertebro-basilar artery syndrome and blurred vision was initially diagnosed as suffering from a collagen disease affecting the retina and CNS. Treatment with systemic steroids induced an apparent remission. However, a rapid deterioration of her condition prompted a reevaluation of the diagnosis and treatment. Ophthalmoscopic examination disclosed numerous ischemic foci in both eyes, scattered superficial hemorrhages, and neovascular tufts on the optic nerves. The possibility that both the cerebral and ocular phenomena were the results of systemic showering of emboli was raised. Careful two-dimensional echo cardiography revealed a mitral mass compatible with myxoma of the left atrium. The difficult differential diagnosis of combined encephalopathy and retinopathy is discussed.
Similar content being viewed by others
References
Barnett HJM, Boughner DR, Taylor DW, Cooper PE, Kostuk WJ, Nichol PM (1980) Further evidence relating mitral-valve prolapse to cerebral ischemic events. N Engl J Med 302:139–144
BenEzra D (1980) Diseases of the choroid and anterior uvea. In: Michaelson IC (ed) Textbook of the fundus of the eye. Churchill and Livingstone, Edinburgh London, p 703
Coppeto JR, Currie JN, Monteiro MLR, Lessell S (1984) A syndrome of arterial-occlusive retinopathy and encephalopathy. Am J Ophthalmol 98:189–202
Gass JDM, Tiedeman J, Thomas MA (1986) Idiopathic recurrent branch retinal arterial occlusion. Ophthalmology 93:1148–1157
Gold D, Feiner L, Henkind P (1977) Retinal arterial occlusive disease in systemic lupus erythematosus. Arch Ophthalmol 95:1580–1585
Jampol LM, Isenberg SJ, Goldberg MF (1976) Occlusive retinal arteriolitis with neovascularization. Am J Ophthalmol 81:583–589
Kelley JS, Randall HG (1979) Peripheral retinal neovascularization in rheumatic fever. Arch Ophthalmol 97:81–83
Manschot WA (1959) Embolism of the central retinal artery originating from an endocardial myxoma. Am J Ophthalmol 48:381–385
Pfaffenbach DD, Hollenhorst RW (1973) Microangiopathy of the retinal arterioles. J Am Med Assoc 225:480–483
Susac JO, Hardman JM, Selhorst JB (1979) Microangiopathy of the brain and retina. Neurology 29:313–316
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Matamoros, N., BenEzra, D. Bilateral retinopathy and encephalopathy. Graefe's Arch Clin Exp Ophthalmol 227, 39–41 (1989). https://doi.org/10.1007/BF02169823
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02169823