Central Retinal Artery Obstruction in Protein S Deficiency

ABSTRACT

PURPOSE: To report a case of central retinal artery obstruction (CRAO) caused by protein S deficiency. CASE SUMMARY: A 36-year-old man presented with acutely reduced visual acuity in the right eye. The patient had no other diseases such as diabetes mellitus or hypertension. The visual acuity was 20/20 in the right eye and light perception in the left eye. Afferent pupillary defect was observed in theleft eye. Fundus examination showed diffuse retinal opacification and a cherry-red spot at the macula. Thus the patient was diagnosed with CRAO in the left eye. There were no abnormal findings on routine hematologic tests including blood coagulation test. Protein C activity, antithrombin III activation, anticardiolipin antibody were within normal limits but protein S activity was decreased. Thus, the patient was diagnosed with CRAO with protein S deficiency. CONCLUSIONS: Coagulation factors such as protein S need to be measuredin cases of CRAO in young patients without medical problems.