Ocular symptoms in association with antiphospholipid antibodies.
OBJECTIVE
To describe the clinical and serologic findings of 50 antiphospholipid antibody (APA)-positive patients within a retrospective study.


METHODS
Measurement of visual acuity, slit-lamp biomicroscopy, tonometry, fundus examination and perimetry. Laboratory tests were performed for detection of APA against thromboplastin and cardiolipin. Antinuclear antibodies (ANA), antibodies to dsDNA, antithyroidal and antiparietal antibodies were also tested.


RESULTS
A combination of both transient and permanent visual disturbances was noticed in more than half of the patients. Transient visual disturbances included transient blurred vision, partial defects of the visual fields and amaurosis fugax. The most frequent permanent abnormalities were optic atrophy in 20 patients, due to AION in 9 cases, and disturbances of the choroidal circulation in 17 patients. Fourty-six patients had positive levels of thromboplastin APA; cardiolipin APA were found to be increased in 36 patients.


CONCLUSIONS
We did not find a clear correlation between APA activity or the immunoglobulin classes in the individual and the severity of the ocular disease. The benefit from a therapy with the antiplatelet agent acetylsalicylic acid was evident in a reduction of the patients' transient visual disturbances and, in most cases, no further progression of permanent visual field defects was observed.
Universitäts-Augenklinik II, Tübingen, Germany. BMKottler@aol.com
B
B
Leo-Kottler
R
R
Klein
P A
PA
Berg
E
E
Zrenner
D000293:Adolescent; D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D001241:Aspirin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009896:Optic Atrophy / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010431:Pentoxifylline / Q000627:therapeutic use; D012189:Retrospective Studies; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D014792:Visual Acuity; D014794:Visual Fields
D017152:Antibodies, Antiphospholipid; D001241:Aspirin; D010431:Pentoxifylline