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