Antiphospholipid Syndrome Ahmed Magdy Bedda, MD, PhD Professor Ophthalmology Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University

History 29 year old lady complaining of bilateral drop of vision since 3.5 months 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 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 had been diagnosed with Antiphospholipid syndrome with positive lupus anticoagulant and anti-cardiolipin antibodies

Ocular examination BCVA 4/60 OD 6/18 OS BCVA 4/60 OD 6/18 OS anterior segment was unremarkable anterior segment was unremarkable fundus fundus wedge-shaped triangular choroidal hypoperfusion defects (Amalric sign) wedge-shaped triangular choroidal hypoperfusion defects (Amalric sign) with pigmentary changes in the setting of choroidal infarcts with pigmentary changes in the setting of choroidal infarcts

Fundus at presentation

Conclusion Amalric sign is a rare clinical sign that indicates choroidal ischemia 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 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 Clinical entities such as malignant hypertension, chronic renal failure, toxemia of pregnancy, collagen vascular diseases, sickle cell disease and vasculitidis have been implicated