Kaliounji Aboud, Alkoutami Sami S, Kaliounji Haya, Tucktuck Marina, John Sabu, McFarlane Samy I
Internal Medicine, State University of New York Downstate Medical Center, New York, USA.
Internal Medicine, East Carolina University, Brody School of Medicine, Greenville, USA.
Cureus. 2023 Jun 5;15(6):e39975. doi: 10.7759/cureus.39975. eCollection 2023 Jun.
Patent foramen ovale (PFO) is a congenital heart anomaly with persistent non-closure of the atrial septum that generally closes six to 12 months after birth in the majority of adults. While remaining asymptomatic in the majority of cases, PFO could lead to paradoxical embolism and cryptogenic strokes in most symptomatic cases. The incidence of small arterial occlusion due to paradoxical emboli is quite uncommon. In this report, we present a case of a 51-year-old man who presented with acute left-sided painless visual loss due to central retinal artery occlusion (CRAO). Stroke work-up and hypercoagulability evaluations were negative. The patient was found to have PFO with the initial presentation as CRAO, a rather rare presentation in the setting of PFO. In this report also, we discuss the clinical presentation, pathogenesis, and the current evidence-based therapeutic options in the management of PFO in adults, highlighting the importance of considering this diagnostic entity in the setting of acute visual loss, as with our case presentation.
卵圆孔未闭（PFO）是一种先天性心脏异常，表现为房间隔持续未闭合，大多数成年人在出生后6至12个月时房间隔会闭合。虽然大多数情况下PFO无症状，但在大多数有症状的病例中，PFO可导致反常栓塞和不明原因的中风。由反常栓塞引起的小动脉闭塞的发生率相当罕见。在本报告中，我们介绍了一名51岁男性的病例，该患者因视网膜中央动脉阻塞（CRAO）出现急性左侧无痛性视力丧失。中风检查和高凝状态评估均为阴性。该患者最初表现为CRAO，被发现患有PFO，这在PFO病例中是一种相当罕见的表现。在本报告中，我们还讨论了成人PFO的临床表现、发病机制以及目前基于证据的治疗选择，强调了在急性视力丧失情况下考虑这一诊断实体的重要性，就像我们的病例展示一样。
