A Rare Cause to Consider in Sudden Vision Loss: Patent Foramen Ovale – A Case Report

Patent foramen ovale (PFO) is a congenital septal defect resulting from the failure of closure of the interatrial communication that normally seals after birth. In conditions leading to a sudden increase in intrathoracic or intra-abdominal pressure, right-to-left shunting across the atria may occur, which may lead to cryptogenic stroke in children and young adults without traditional risk factors.

An 18-year-old woman experienced sudden unilateral vision loss 6 months ago, and no pathology was detected during the initial ophthalmological and neurological examination. Subsequent cardiac examination and echocardiography revealed a PFO. The patient, who had no comorbidities, attributed the sudden vision loss to the PFO, and percutaneous closure was performed. In patients presenting with transient sudden visual loss, clinicians should consider PFO in the absence of additional risk factors or when no definitive diagnosis can be established. In cases of cryptogenic stroke where the etiology is difficult to determine, it is crucial to evaluate for and manage a patent foramen ovale (PFO) to prevent recurrent strokes and permanent visual impairment. To the best of our knowledge, this case represents one of the few reported instances of transient visual loss associated with PFO in the literature.

Keywords: patent foramen ovale, amaurosis fugax, cryptogenic stroke