Transient Visual Loss in a 60-year-old Man

A 60-year-old man after 5 years of recurrent episodic amaurosis fugax, always resolving, experienced an incident of visual loss that was permanent. Computed tomography and magnetic resonance imaging were normal. Transesophageal echocardiogram and carotid duplex scan ruled out embolic sources from the heart and neck vessels. Blood tests for hypercoagulability found elevated APTT not correcting with 50:50 dilution with control serum, owing to the presence of a lupus anticoagulant. The patient was treated with warfarin, baby aspirin, and a calcium channel blocker and has not had a recurrence of permanent visual loss in 17 years.