Spontaneous bilateral peripapillary, subhyaloid and vitreous hemorrhage with only minor platelet deficit in idiopathic thrombocytopenic purpura

Wan-Wei, Loo; Tengku-Norina, Tuan-Jaffar; Azma-Azalina, Ahmad-Alwi; Zulkifli, Abdul-Ghani; Zunaina, Embong

doi:10.2147/imcrj.s55017

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…The most common signs and symptoms of ITP include fatigue, petechiae, bleeding gums and epistaxis, hematuria, melena or rectal bleeding, profuse bleeding during surgery, and menorrhagia [ 5 ]. Ocular manifestations of ITP include sub-hyaloid, vitreous, and spontaneous supra-choroidal hemorrhage [ 12 , 13 ]. Hyphema in this case was the first and only sign of this hematologic abnormality.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Bilateral Hyphema in a Patient With Idiopathic Thrombocytopenic Purpura

Atzamoglou¹,

Markopoulos²,

Spanos³

et al. 2023

Cureus

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The aim of this case report is to present an unusual case of idiopathic thrombocytopenic purpura (ITP) with bilateral spontaneous hyphema. It refers to an 82-year-old Caucasian woman who presented with acute unilateral vision loss. The patient’s medical history includes arterial hypertension, hypothyroidism, and uneventful bilateral cataract surgery. Bilateral anterior chamber hyphema was noted on gonioscopy, along with unilateral corneal edema. Hematology workup set the diagnosis of ITP. The cause of spontaneous bleeding in ITP patients is explained by the "second hit" hypothesis, suggesting that a secondary factor such as high blood pressure or minor trauma is necessary to cause rupture to a vessel’s wall, which is already affected by the low platelet counts. The authors propose that, in this patient, the "second hit" was likely due to basement membrane alterations caused by arterial hypertension. The rarity of bilateral spontaneous hyphema cases and possible etiologies are emphasized.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Bilateral Hyphema in a Patient With Idiopathic Thrombocytopenic Purpura

Atzamoglou¹,

Markopoulos²,

Spanos³

et al. 2023

Cureus

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“…Preretinal haemorrhage may resolve spontaneously. Wan-Wei et al [ 13 ] have reported in their case report that there was spontaneous recovery of preretinal haemorrhage and improvement of vision with oral prednisolone. However, in some patients, spontaneous resolution of preretinal haemorrhages may take months especially large and dense haemorrhage [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Resolution of Preretinal Haemorrhage with Intravitreal Ranibizumab

Noorlaila

Zunaina

Raja-Azmi

2016

Case Reports in Ophthalmological Medicine

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We would like to report two cases of preretinal haemorrhage from two different aetiology courses of bleeding being treated with intravitreal ranibizumab and its outcome. Our first case was a 39-year-old man with a diagnosis of severe aplastic anaemia that presented with bilateral premacular haemorrhages in both eyes. His right eye vision was 6/45 and it was counting finger in the left eye. He was treated with intravitreal ranibizumab once to the right eye and twice to the left eye. Right eye showed complete resolution of premacular haemorrhage and minimal residual premacular haemorrhage in the left eye at 3 months after initial presentation. Our second case was a 32-year-old healthy teacher that presented with preretinal haemorrhage at superotemporal region extending to macular area in left eye secondary to valsalva retinopathy. Her left vision was counting finger. She was treated with single intravitreal ranibizumab to the left eye. There was significant reduction of premacular haemorrhage and her left eye vision improved to 6/6 at 10 weeks after injection. Both cases had favourable outcome with intravitreal ranibizumab and can be considered as nonsurgical treatment option in treating premacular haemorrhage.

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“…In a reported case of ITP, vitrectomy was offered to resolve a subhyaloid and vitreous hemorrhage, but the patient declined intervention. The underlying condition of ITP was treated medically and the hemorrhages improved with recovery of vision [ 3 ]. Mansour et al reported a series of 37 patients with aplastic anemia who experienced retinal hemorrhages, some of which were sub-ILM.…”

Section: Introductionmentioning

confidence: 99%

Valsalva-Like Retinopathy Secondary to Pancytopenia following Induction of Etoposide and Ifosfamide

Prinzi

Saraf

Desai

et al. 2015

Case Reports in Ophthalmological Medicine

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Etoposide and ifosfamide are chemotherapeutic agents used frequently in the treatment of sarcomas and hematologic malignancies. Ocular side effects are rarely reported. We describe a case of a patient on etoposide and ifosfamide who presented with unilateral vision loss, anemia, and thrombocytopenia. The patient was found to have a large subinternal limiting membrane hemorrhage in the right eye that is thought to be related to his anemia and thrombocytopenia. The hemorrhage resolved spontaneously after 10 days. This case illustrates how bone marrow suppression by chemotherapeutic agents may indirectly contribute to retinal hemorrhages resulting in at least transient vision loss.

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Spontaneous bilateral peripapillary, subhyaloid and vitreous hemorrhage with only minor platelet deficit in idiopathic thrombocytopenic purpura

Cited by 4 publications

References 9 publications

Spontaneous Bilateral Hyphema in a Patient With Idiopathic Thrombocytopenic Purpura

Spontaneous Bilateral Hyphema in a Patient With Idiopathic Thrombocytopenic Purpura

Successful Resolution of Preretinal Haemorrhage with Intravitreal Ranibizumab

Valsalva-Like Retinopathy Secondary to Pancytopenia following Induction of Etoposide and Ifosfamide

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