Cloth-particle retinal emboli from artificial cardiac valves.

Two patients with prosthetic mitral valves had ocular complications. A 28-year-old woman suffered recurrent episodes of bilateral retinal embolization and consequent loss of useful vision over a period of two years despite therapeutic anticoagulation. Replacement of the valve was followed by cessation of the embolization. A 52-year-old man noted the abrupt onset of blurred vision in his right eye. Visual acuity was 6/6 (20/20) bilaterally, but the right eye had many retinal emboli of varying shapes. Both patients had long-standing mitral valve disease, but ocular symptoms developed only after the implantation of a cloth-covered mitral valve prosthesis. To the best of our knowledge, retinal emboli from cloth-covered cardiac valve prostheses have not been previously reported. Patients with such prostheses and ocular complaints who have adequate anticoagulation therapy should be carefully examined for retinal emboli. If emboli are present, valve dysfunction is possible and valve replacement may be necessary.