Branch retinal artery occlusion in the Churg-Strauss syndrome.

Amaurosis fugax followed by retinal infarction occurred as an early manifestation of exacerbation in a 46-year-old woman with allergic angiitis and granulomatosis (Churg-Strauss syndrome). There was evidence of widespread intraluminal branch retinal artery occlusions without accompanying retinal vasculitis. Low molecular weight dextran and heparin, in addition to systemic steroid therapy, appeared to be beneficial. A review of the ophthalmic manifestations of the Churg-Strauss syndrome and of other hypereosinophilic conditions suggests that thromboembolism resulting from a hypercoagulable state may be as important as vasculitis in causing visual symptoms. Specific therapy attempting to alter blood coagulation and rheology may have an important role in these conditions.