Antiphospholipid Syndrome
Ahmed Magdy Bedda, MD, PhDProfessor OphthalmologyRowayda M. Amin, MSc
Assistant Lecturer OphthalmologyAlexandria University
History 29 year old lady complaining of bilateral drop
of vision since 3.5 months history of preeclampsia and previous 2 attacks
of left lower limb thrombosis over the past 3 years
had been diagnosed with Antiphospholipid syndrome with positive lupus anticoagulant and anti-cardiolipin antibodies
Ocular examination
BCVA 4/60 OD 6/18 OS anterior segment was unremarkable fundus
wedge-shaped triangular choroidal hypoperfusion defects (Amalric sign)
with pigmentary changes in the setting of choroidal infarcts
Fundus at presentation
Conclusion Amalric sign is a rare clinical sign that
indicates choroidal ischemia It is believed to represent occlusion of the
long or short posterior ciliary arteries (PCA) or their branches
Clinical entities such as malignant hypertension, chronic renal failure, toxemia of pregnancy, collagen vascular diseases, sickle cell disease and vasculitidis have been implicated