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Case report
Central retinal artery occlusion from Streptococcus gallolyticus endocarditis
  1. Rita Serras-Pereira1,
  2. Diogo Hipolito-Fernandes1,
  3. Luísa Azevedo2 and
  4. Luísa Vieira1
  1. 1Department of Ophthalmology, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
  2. 2Department of Internal Medicine, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
  1. Correspondence to Dr Diogo Hipolito-Fernandes; cdiogo777{at}


Central retinal artery occlusion (CRAO) is a rare but blinding disorder. We present a case of a 81-year-old woman with multiple cardiovascular comorbidities admitted to the emergency department due to sudden, painless vision loss on left eye (oculus sinister (OS)) on awakening. The patient also reported long standing fatigue associated with effort that started 4 months before admission. She presented best corrected visual acuity of counting fingers OS. Funduscopy OS revealed macular oedema with cherry red spot pattern. Blood cultures came positive for Streptococcus gallolyticus in the context of a bacteremia and native mitral valve vegetation identified on transoesophageal echocardiography. CRAO of embolic origin was admitted in the context of an infective endocarditis. CRAO can be the first manifestation of a potentially fatal systemic condition and thus multidisciplinary approach is warranted with close collaboration between ophthalmologists and internists in order to provide proper management and the best possible treatment.

  • retina
  • valvar diseases

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  • Contributors RS-P: data acquisition, data analysis and paper conception. DH-F: data analysis and paper conception. LA and LV: data aquisition, data analysis and paper revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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