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Title	Peripheral ischemic retinopathy and neovascularization in a patient with bacterial endocarditis
Abstract Nr.	1070

Purpose	To describe a patient with peripheral retinal ischemia and neovascularization who was diagnosed with streptococcus mitis - induced bacterial endocarditis.
Methods	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.
Results	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.
Conclusion	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.

Authors 1

Last name	KREPS
Initials	EO
Department	Department of Ophthalmology
City	University Hospital Ghent

Authors 2

Last name	De Schryver
Initials	I
Department	Department of Ophthalmology
City	University Hospital Ghent

Authors 3

Last name	Hoornaert
Initials	KP
Department	Department of Ophthalmology
City	University Hospital Ghent

Authors 4

Last name	Smith
Initials	V
Department	Department of Rheumatology
City	University Hospital Ghent

Authors 5

Last name	De Zaeytijd
Initials	J
Department	Department of Ophthalmology
City	University Hospital Ghent