CHOROIDAL ISCHEMIA IN PATIENTS WITH CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME: A CASE SERIES

PURPOSE: To report three cases of acute choroidal ischemia in patients diagnosed with catastrophic antiphospholipid syndrome. METHODS: The medical and imaging records of patients with catastrophic antiphospholipid syndrome were retrospectively reviewed. Patients underwent retinal imaging, including fundus photography, spectral-domain optical coherence tomography, fluorescein and indocyanine green angiography. RESULTS: This report summarizes three cases of pregnant women (six eyes) with catastrophic antiphospholipid syndrome and posterior ocular involvement. Spectral-domain optical coherence tomography revealed multiple subretinal detachments. Fluorescein and indocyanine green angiography showed triangular nonperfused areas consistent with Amalric triangular choroidal infarction and multiple spots of subretinal leakage. Patients were hospitalized in intensive care unit for treatment with corticosteroids, anticoagulants, and plasma exchanges/intravenous immunoglobulins. Full recovery was observed in all cases. CONCLUSION: The presence of acute choroidal ischemia in patients with antiphospholipid syndrome should alert ophthalmologists to the possibility of catastrophic antiphospholipid syndrome, which is a life-threatening disease. Patients should immediately be referred to a specialist.