Effective suppression of crescendo amaurosis fugax associated with anti-phospholipid antibodies by low dose aspirin

Abstract

A young woman aged 23 experienced binocular partial amaurosis fugax attacks for at least one year with crescendo frequency. Clinical and laboratory evaluations were normal except for the demonstration in her plasma of autoantibodies against phospholipids and mild erythrocyte sedimentation rate (ESR) elevation. Despite normal appearing blood vessels on fundoscopy, vasculitis and lupus erythematosus were suspected and high dose steroid therapy initiated, but the attacks continued. Addition of aspirin (100 mg daily), however, stopped the attacks immediately and has left the patient asymptomatic for three months now despite steroid withdrawal. Amaurosis fugax was presumably caused by phospholipid antibody-induced platelet aggregation which, owing to special features of the retinal vascular supply, led only to ocular symptoms.

Key Words:

• anti-phospholipid antibodies
• amaurosis fugax
• aspirin
• retinal blood vessels
• cerebral angiitis