Antiphospholipid antibodies and retinal vascular disease.
BACKGROUND
Antiphospholipid antibody retinopathy is a rare and poorly defined clinical entity in which the proper diagnosis has important ocular and systemic implications. The clinical course of five patients with antiphospholipid antibody retinopathy is described and the role of such antibodies in idiopathic retinal venous occlusive disease is investigated.


METHODS
Five case reports are presented highlighting the presentation, course, therapy, associations and outcomes of patients with antiphospholipid antibody retinopathy. In addition, twenty additional patients presenting with idiopathic retinal venous occlusive disease were tested for the presence of antiphospholipid antibodies.


RESULTS
All five patients with antiphospholipid antibody retinopathy had diffuse retinal vascular occlusion. All five patients presented with associated rheumatologic disease, including three with lupus or lupus-like disease. Antibodies to antiphospholipid were not detected in any of the twenty patients with idiopathic retinal venous occlusive disease. Prompt panretinal photocoagulation together with varying regimens of corticosteroids, immunosuppressives, or warfarin was partially successful in stabilizing the ocular and systemic disease.


CONCLUSIONS
The diagnosis of antiphospholipid antibody retinopathy should be suspected in patients with diffuse retinal vaso-occlusion, particularly when characterized by involvement of both arteries and veins, neovascularization at presentation, and symptoms of symptoms of systemic rheumatologic disease. Antiphospholipid antibodies do not appear to play an important role in idiopathic retinal vein occlusions.
Dunn
J P
JP
Wilmer Ophthlmological Institute, Department of Ophthalmology, Jhons Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Noorily
S W
SW
Petri
M
M
Finkelstein
D
D
Rosenbaum
J T
JT
Jabs
D A
DA
D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000473:pathology; D001327:Autoimmune Diseases / Q000150:complications* / Q000276:immunology; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology; D008028:Light Coagulation; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology; D012161:Retinal Artery / Q000473:pathology; D012164:Retinal Diseases / Q000209:etiology* / Q000628:therapy; D012166:Retinal Hemorrhage / Q000209:etiology / Q000628:therapy; D012170:Retinal Vein Occlusion / Q000209:etiology / Q000473:pathology; D012595:Scleroderma, Systemic / Q000150:complications
D017152:Antibodies, Antiphospholipid