# Central retinal artery occlusion in a patient with aortic valve papillary fibroelastoma: a case report

## TL;DR

A rare heart tumor caused sudden blindness in one eye by blocking a retinal artery, highlighting the need for thorough cardiac imaging.

## Contribution

This case report highlights central retinal artery occlusion as a rare first manifestation of aortic valve papillary fibroelastoma.

## Key findings

- A 61-year-old female presented with monocular vision loss due to central retinal artery occlusion.
- Transesophageal echocardiography identified a small mass on the aortic valve, later confirmed as papillary fibroelastoma.
- Surgical excision of the tumor prevented further embolic events.

## Abstract

Cardiac papillary fibroelastoma are rare benign tumours of the endocardium, often arising from heart valves. Despite their benign histology, papillary fibroelastoma carry high embolic potential and can lead to ischaemic events. In contrast to stroke, ocular embolization including central retinal artery occlusion is a rather rare first manifestation.

We report a 61-year-old female with sudden painless monocular vision loss due to central retinal artery occlusion. Initial stroke and cardiovascular work-up revealed a very small floating mass (0.6 × 0.4 × 0.2 cm) on the aortic valve by transesophageal echocardiography. The patient underwent successful surgical excision, with histopathology confirming papillary fibroelastoma.

Central retinal artery occlusion as a primary manifestation of papillary fibroelastoma highlights the embolic potential of these tumours. Multimodality imaging, especially transesophageal echocardiography, is crucial in diagnosis. Even very small papillary fibroelastoma may cause devastating embolic events such as irreversible monocular blindness. Surgical excision is the treatment of choice to prevent recurrence.