White thread-like retinal arterioles associated with antiphospholipid antibody syndrome

Abstract Background: Report of 2 patients with antiphospholipid antibody syndrome (APS) who had elevated anti-β 2 -glycoprotein I antibodies and showed white thread-like retinal arterioles. Cases: A complete ophthalmological examination was conducted on 2 patients who presented with blurred or distorted vision. Fluorescein angiography was used to examine the integrity of the retinal circulatory system. Laboratory blood studies were conducted. Observations: In both patients, some of the major retinal arterioles appeared white and had a thread-like appearance. Fluorescein angiography demonstrated progressive occlusion or stenosis of these major arterioles with extensive insufficiency of the regional capillary bed. Patient 2 had systemic lupus erythematosus and was treated with oral corticosteroid and aspirin. Recanalization occurred during a 3-year follow-up in one of the patients. Conclusions: APS should be considered in cases of white thread-like retinal arterioles. Occlusion of the retinal arterioles in APS may be progressive and responsible for the chronic hypoxia of the retina.