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TitrePeripheral ischemic retinopathy and neovascularization in a patient with bacterial endocarditis
Abstract Nr.1070
ButTo describe a patient with peripheral retinal ischemia and neovascularization who was diagnosed with streptococcus mitis - induced bacterial endocarditis.
MéthodesA 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.
RésultatsBCVA 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.
ConclusionPeripheral 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.
Auteur 1
NomKREPS
InitialesEO
InstitutDepartment of Ophthalmology
VilleUniversity Hospital Ghent
Auteur 2
NomDe Schryver
InitialesI
InstitutDepartment of Ophthalmology
VilleUniversity Hospital Ghent
Auteur 3
NomHoornaert
InitialesKP
InstitutDepartment of Ophthalmology
VilleUniversity Hospital Ghent
Auteur 4
NomSmith
InitialesV
InstitutDepartment of Rheumatology
VilleUniversity Hospital Ghent
Auteur 5
NomDe Zaeytijd
InitialesJ
InstitutDepartment of Ophthalmology
VilleUniversity Hospital Ghent
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