Tran Kimberly D, Read Sarah P, Patel Nimesh A, Flynn Harry W, Schatz Norman J
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States.
Am J Ophthalmol Case Rep. 2017 Jul 8;7:143-145. doi: 10.1016/j.ajoc.2017.07.005. eCollection 2017 Sep.
To describe the importance of considering vaso-occlusive disease on the differential diagnosis of a patient presenting with amaurosis fugax (AF) and unilateral cotton wool spots (CWS).
A 69-year-old female with history of obesity, hyperlipidemia and recent orthopedic surgery, presented with 3 days of worsening monocular AF and CWS in the right eye. She was diagnosed with antiphosphospholipid syndrome based on positive serologic testing for antiphosphatidylserine IgM, anticardiolipin IgM. The patient was treated with lipid lowering medication, long-term aspirin, and has followed a weightloss and physical therapy program under medical supervision. The CWS resolved and AF symptoms have not recurred.
Antiphospholipid syndrome can be considered in the differential diagnosis of patients presenting with AF, assymetric CWS, and/or rapid progression of symptoms.
描述在对出现一过性黑矇（AF）和单侧棉絮斑（CWS）的患者进行鉴别诊断时考虑血管闭塞性疾病的重要性。
一名69岁女性，有肥胖、高脂血症病史且近期接受过骨科手术，右眼出现3天的单眼AF和CWS症状加重。基于抗磷脂酰丝氨酸IgM、抗心磷脂IgM的血清学检测呈阳性，她被诊断为抗磷脂综合征。该患者接受了降脂药物、长期阿司匹林治疗，并在医学监督下遵循了减肥和物理治疗方案。CWS症状消失，AF症状未再复发。
在对出现AF、不对称CWS和/或症状快速进展的患者进行鉴别诊断时，可考虑抗磷脂综合征。
