Vision Defect Owing to Metastasis
As an addendum to the diagnostic evaluation of cardiac tumors, especially of metastatic atrial myxoma (1), we wish to add that the eye may also be affected. We reported the case of a 20 year old woman with a history of three years’ recurrent, sudden-onset, unexpectedly occurring unilateral vision defects accompanied by headache. The headaches were initially misdiagnosed as migraine attacks. Ultimately, an ophthalmological examination found a recent occlusion of the retinal artery branch. The ophthalmologist organized an echocardiogram and a myxoma in the left atrium was found, which was then successfully surgically removed. In metastatic atrial myxoma, ocular infarctions are common, in addition to cerebral or peripheral infarctions. Many publications have reported on this; the literature includes descriptions of central artery occlusion, cerebral nerve palsy—for example, oculomotor nerve palsy—homonymous hemianopsia, or nystagmus.
Prof. Dr. med. Dieter Schmidt
|1.||Hoffmeier A, Sindermann JR, Scheld HH, Martens S: Cardiac tumors—diagnosis and surgical treatment. Dtsch Arztebl Int 2014; 111: 205–11. VOLLTEXT|
|2.||Schmidt D, Hetzel A, Geibel-Zehender A: Retinal arterial occlusion due to embolism of suspected cardiac tumors – report on two patients and review of the topic. Eur J Med Res 2005; 10: 296–304. MEDLINE|