Titel | Peripheral ischemic retinopathy and neovascularization in a patient with bacterial endocarditis |
Abstract Nr. | 1070 |
Doel | To describe a patient with peripheral retinal ischemia and neovascularization who was diagnosed with streptococcus mitis - induced bacterial endocarditis. |
Methodes | A 57-year old man presented with a history of a rapidly progressive, bilateral, painless visual loss. He also suffered from pain in the neck and lower back and a weight loss of 10 kg. He underwent full ophthalmologic work-up, laboratory investigations and imaging of the spine. |
Resultaten | BCVA was reduced to 5/10 in the right eye and 6/10 in the left eye. Fundoscopy showed rare intraretinal hemorrhages including few Roth spots and cotton-wool lesions. However large areas of peripheral retinal ischemia and neovascularization were detected on fluorescein angiography. General history was significant for diabetes mellitus and low-grade mitral valve insufficiency. Urgent systemic work-up revealed inflammation (CRP of 38.8mg/L), normal blood counts and protein electrophoresis, and cervical and lumbal spondylodiscitis on MRI. A transesophageal echocardiography with mitral valve vegetations confirmed the diagnosis of bacterial endocarditis. Streptococcus mitis could be identified as causative organism. |
Conclusie | Peripheral retinal ischemia and neovascularization were previously unrecognized as a feature of infectious endocarditis. Therefore, their presence, apart from the classic Roth spots should prompt the consideration of infectious endocarditis in the etiologic work-up. |
Naam | KREPS |
Initialen | EO |
Instituut | Department of Ophthalmology |
Stad | University Hospital Ghent |
Naam | De Schryver |
Initialen | I |
Instituut | Department of Ophthalmology |
Stad | University Hospital Ghent |
Naam | Hoornaert |
Initialen | KP |
Instituut | Department of Ophthalmology |
Stad | University Hospital Ghent |
Naam | Smith |
Initialen | V |
Instituut | Department of Rheumatology |
Stad | University Hospital Ghent |
Naam | De Zaeytijd |
Initialen | J |
Instituut | Department of Ophthalmology |
Stad | University Hospital Ghent |