Multiple Successive Branch Retinal Artery Occlusions in a Patient With Antiphospholipid Syndrome Despite Anticoagulation

Abstract

Purpose: To describe a patient with antiphospholipid syndrome presenting with branch retinal artery occlusions (BRAO) despite anticoagulation. Methods: A single case was evaluated. Results: A 53-year-old woman with antiphospholipid syndrome on anticoagulation presented for a routine ophthalmic examination. She had no visual complaints, and the visual acuity was 20/25⁻¹ OD and 20/30⁻¹ OS. A BRAO was found in the right eye. Despite treatment with aspirin, warfarin, prednisone, plasmapheresis, and rituximab, multiple new occlusions were found when the patient returned the next month. She ultimately had a stroke, which led to her death. Conclusions: This case underscores the importance of interdisciplinary care for patients with antiphospholipid syndrome presenting with BRAOs despite anticoagulation.