[Retinal vascular occlusion and primary antiphospholipid syndrome. Report of 2 cases].
INTRODUCTION: The antiphospholipid syndrome is characterized by the association of antiphospholipid antibodies and occlusive vascular events. The ocular vascular damage is described in the literature and may reveal the syndrome. It's diagnosis is important because this disease, which generally affects young people, may endanger ocular and vital prognosis. Two cases are reported. PATIENTS: Two young people aged 22 and 32 presented with a sudden unilateral loss of vision. In both cases, fundus examination and fluorescein angiography revealed a severe retinal vascular occlusion. For one patient, an antiphospholipid syndrome was discovered during etiological check-up. for the second one, it was associated with a heterozygote state mutation of Leiden V factor. In both cases the visual function of the affected eye was lost. DISCUSSION: In most cases central artery or vein occlusion means atherosclerosis. However, other etiologies must be studied in young patients. According to several studies: antiphospholipid syndrome has been detected in 5% to 33% of the patients showing a major vascular retinal obstruction. The association of thrombophilia must be considered because it increases the risk of thrombotic recurrence. CONCLUSION: The antiphospholipid syndrome must be studied in cases of numerous and severe retinal vascular obstruction occurring in young patients, even if vascular risks exist. This diagnosis is important because it may imply a long-lasting anticoagulative or an antiaggregative treatment to significantly reduce the risk of recurrent thrombotic events.