Bilateral Central Retinal Vein Occlusion in Patient with Disseminated Intravascular Coagulation.
10.3341/jkos.2011.52.8.1005
- Author:
Kyoung In JUNG
1
;
Hae Ri YUM
;
In Tae KIM
Author Information
1. Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Central retinal vein obstruction;
Disseminated intravascular coagulation
- MeSH:
Acidosis;
Adult;
Dacarbazine;
Disseminated Intravascular Coagulation;
Eye;
Female;
Fingers;
Humans;
Plasma;
Plasma Exchange;
Purpura, Thrombotic Thrombocytopenic;
Retinal Vein;
Retinaldehyde;
Thymine Nucleotides;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2011;52(8):1005-1008
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of bilateral central retinal vein occlusion (CRVO) as one of the initial signs of disseminated intravascular coagulation (DIC). CASE SUMMARY: A 33-year-old woman with a history of pregnancy-induced thrombotic thrombocytopenic purpura presented to our hospital with bilateral visual loss. On her initial visit, visual acuity was counting fingers at 30 cm in both eyes. Based on the findings of a funduscopic examination, the patient was diagnosed with bilateral CRVO. Laboratory tests confirmed the diagnosis of DIC combined with thrombotic thrombocytopenic purpura (TTP). Plasma exchange and transfusion of cryoprecipitate with fresh frozen plasma was performed. The ocular fundus findings did not improve. Despite medical treatment, the patient's systemic condition deteriorated and she died of metabolic acidosis two weeks later. CONCLUSIONS: Bilateral central retinal vein occlusion occurred as a sign of aggravation of preexisting TTP and progression to DIC in the presented case. In patients with severe bilateral retinal venous changes, there should be a very high level of suspicion for presence or progression of systemic disease, with the possibility of effective early systemic evaluation and therapy.