Copyright 2001 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2001
A 14-YEAR-OLD girl had experienced general fatigue, weight loss, and
fever for 3 months when she developed sudden unilateral visual loss. Visual
acuity in the right eye was no light sense. Ophthalmologic examination revealed
a combined occlusion of the central retinal artery and vein on the first day
(Figure 1 and Figure 2) and flame-shaped retinal hemorrhage on the second day
(Figure 3). She was diagnosed as
having infective endocarditis (IE) with group D streptococcus. Congenital
atrial septal defect and mitral valve insufficiency were also found, which
probably caused IE and subsequent ophthalmic events. Despite treatment with
fibrinolysis (urokinase and low molecular dextran; Otsuka Pharmaceutical Co
Ltd, Tokyo, Japan), her visual acuity improved only to hand movement with
resolution of the cherry red spot. Two weeks after the first ophthalmologic
examination, she underwent mitral valve replacement and surgery to close the
atrial septal defect. After 10 years of follow-up, her visual acuity in the
right eye has remained hand movement. No iris neovascularization has developed.
Kato T, Takeda Y, Matsuyama S, Mishima HK. Combined Occlusion of the Central Retinal Artery and Vein in a Pediatric Patient Secondary to Infective Endocarditis. Arch Ophthalmol. 2001;119(12):1868–1869. doi:10.1001/archopht.119.12.1868
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