Primary antiphospholipid syndrome masquerading as diabetic retinopathy

Background: Primary antiphospholipid syndrome (PAPS) is a thrombotic condit ion which characteristically includes ocular vaso-occlusive pathology. Case: We present the case of a 47-year-old woman with PAPS presenting with retinal vascular leakage. Observations: Vascular leakage was an incidental finding on fundoscopy in a myopic Chinese woman, and initially this was diagnosed as diabetic retinop athy. However, a glucose tolerance test was negative. Subsequently, signs o f retinal vaso-occlusion developed. Previous subclinical cerebral thrombosi s, mild thrombocytopaenia and positive tests for antiphospholipid antibodie s were consistent with the diagnosis of PAPS. Anticoagulation therapy with warfarin prevented further thrombotic episodes. Conclusion: The possibility of PAPS should be considered in patients presen ting with retinal vascular disease without obvious vascular risk factors. J pn J Ophthalmology 2001;45:105-108.