Ma Jeffrey H, Gill Manjot K
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Am J Ophthalmol Case Rep. 2018 Jan 31;10:25-27. doi: 10.1016/j.ajoc.2018.01.038. eCollection 2018 Jun.
We report the case of a central retinal artery occlusion secondary to presumed embolus from a calcified amorphous tumor of the heart, a very rare non-neoplastic cardiac mass.
A 60-year-old female presented with acute unilateral vision loss of the left eye. Examination revealed hand motion visual acuity of the left eye and a left relative afferent pupillary defect. Fundoscopy showed whitening of the macula with a cherry red spot, consistent with a central retinal artery occlusion. Initial workup was unremarkable, including hypercoagulability labs, magnetic resonance imaging of the brain, and magnetic resonance angiography of the head and neck. Transthoracic echocardiogram (TTE) showed calcification of the mitral valve but no masses. Subsequently, transesophageal echocardiogram (TEE) was performed, which revealed a mobile calcified amorphous tumor of the heart.
Calcified amorphous tumor of the heart is a very rare cardiac mass that may cause retinal artery occlusion. TEE is a more sensitive imaging modality to assess for potential cardio-embolic sources if TTE is unrevealing.
我们报告一例因心脏钙化性无定形肿瘤（一种非常罕见的非肿瘤性心脏肿物）引发的栓子导致视网膜中央动脉阻塞的病例。
一名60岁女性因左眼急性单眼视力丧失就诊。检查发现左眼手动视力及左相对性传入瞳孔障碍。眼底检查显示黄斑变白伴樱桃红斑，符合视网膜中央动脉阻塞表现。初始检查未见异常，包括高凝状态实验室检查、脑部磁共振成像以及头颈部磁共振血管造影。经胸超声心动图（TTE）显示二尖瓣钙化但未发现肿物。随后进行经食管超声心动图（TEE）检查，发现心脏有一个活动的钙化性无定形肿瘤。
心脏钙化性无定形肿瘤是一种非常罕见的心脏肿物，可能导致视网膜动脉阻塞。如果TTE未发现异常，TEE是评估潜在心源性栓子来源更敏感的成像方式。
