Fatal thrombotic thrombocytopenia purpura presenting with choroidal vasculopathy and serous retinal detachment

Hay-Smith, Graham; Sagoo, Mandeep S.; Raina, Jyoti

doi:10.1038/sj.eye.6702100

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…It has been suggested, therefore, that the ophthalmologist consider TTP in the differential diagnosis of Purtscher retinopathy. Similarly, another rare case presentation is choroidal vasculopathy with serous retinal detachment days before development of classical TTP [21]. Central retinal vein and/or artery occlusions have also been described as presenting features of TTP, initially evaluated by ophthalmologists, which may delay its diagnosis [22][23][24].…”

Section: Unusual Visual Presentations Approximately 8 Tomentioning

confidence: 99%

Atypical presentations of thrombotic thrombocytopenic purpura: A review

Sarode

2008

J of Clinical Apheresis

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Thrombotic thrombocytopenic purpura (TTP) is diagnosed by the presence of microangiopathic hemolytic anemia and thrombocytopenia in a patient who frequently presents with central nervous system involvement and, to a lesser extent, renal dysfunction. Recent understanding of the pathophysiology of TTP due to severe deficiency of von Willebrand factor cleaving protease, known as ADAMTS13, has improved diagnosis of TTP. Once the diagnosis is suspected, life-saving therapeutic plasma exchange therapy is initiated. Occasionally, an unusual clinical presentation makes TTP diagnosis difficult, thus resulting in a delay in the management of TTP. This review highlights a variety of atypical TTP presentations described in the literature. It is intended to bring unusual scenarios to the clinician's awareness, so that timely treatment can be delivered.

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Section: Unusual Visual Presentations Approximately 8 Tomentioning

confidence: 99%

Atypical presentations of thrombotic thrombocytopenic purpura: A review

Sarode

2008

J of Clinical Apheresis

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“…However, there are reports in the literature of exudative retinal detachments in thrombotic microangiopathies that were unrelated to systemic hypertension, substantiating the possibility that our patient's retinal detachments were likely a result of his Opana ER-induced thrombotic microangiopathy and should be managed accordingly. 13 , 14 , 15 …”

Section: Discussionmentioning

confidence: 99%

Bilateral exudative retinal detachments due to thrombotic microangiopathy associated with intravenous abuse of Opana ER

Aseem

Zamora

Kauffman

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report the only known case, to our knowledge, of bilateral exudative retinal detachments in the setting of thrombotic microangiopathy associated with intravenous abuse of extended-release oxymorphone (Opana ER).ObservationsA 35-year-old male presented with headaches and acute, painless vision loss in the context of daily IV abuse of crushed oral Opana ER. The patient was found to have microangiopathic hemolytic anemia (MAHA), acute kidney injury in conjunction with hypertensive crisis and bilateral exudative retinal detachments.Conclusions and importanceBilateral exudative retinal detachments are rare ophthalmic complications that have been reported with thrombotic thrombocytopenic purpura (TTP). Non-TTP thrombotic microangiopathy, initially described as a “TTP-like illness” consisting of MAHA and thrombocytopenia, has been associated with the IV abuse of Opana ER. We report a case of bilateral exudative retinal detachments due to thrombotic microangiopathy in the setting of IV abuse of Opana ER.

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“…Although plasmapheresis has greatly improved the mortality of TTP, it is still a potentially lethal disease [ 9 ]; therefore, it is necessary to avoid any therapeutic delay. Exudative retinal detachment can be the first manifestation of TTP, and ophthalmologists should be aware of this.…”

Section: Discussionmentioning

confidence: 99%

Exudative Retinal Detachment Treatment in a Patient with Thrombotic Thrombocytopenic Purpura

Sampo

Yin

Hoffart

et al. 2016

Case Rep Ophthalmol

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Purpose: We report a case of unilateral exudative retinal detachment in a patient with thrombotic thrombocytopenic purpura (TTP), without associated hypertension, successfully treated with plasmapheresis. Case Report: A 46-year-old woman with a medical history of TTP presented with unilateral exudative retinal detachment. Biological and radiological assessment eliminated other causes of exudative retinal detachment, including hypertension. Plasma exchange was performed, followed by a rapid improvement in visual acuity and total disappearance of serous detachment. Conclusion: Exudative unilateral retinal detachment is a rare complication of TTP and can be successfully treated by plasma exchange.

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Fatal thrombotic thrombocytopenia purpura presenting with choroidal vasculopathy and serous retinal detachment

Cited by 6 publications

References 6 publications

Atypical presentations of thrombotic thrombocytopenic purpura: A review

Atypical presentations of thrombotic thrombocytopenic purpura: A review

Bilateral exudative retinal detachments due to thrombotic microangiopathy associated with intravenous abuse of Opana ER

Exudative Retinal Detachment Treatment in a Patient with Thrombotic Thrombocytopenic Purpura

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