J Korean Ophthalmol Soc.  2011 Aug;52(8):1005-1008. 10.3341/jkos.2011.52.8.1005.

Bilateral Central Retinal Vein Occlusion in Patient with Disseminated Intravascular Coagulation

• Jung KI
• Yum HR
• Kim IT

• KMID: 2214782
• DOI: http://doi.org/10.3341/jkos.2011.52.8.1005

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.

Keyword

Central retinal vein obstruction; Disseminated intravascular coagulation

MeSH Terms

Acidosis
Adult
Dacarbazine
Disseminated Intravascular Coagulation
Eye
Female
Fingers
Humans
Plasma
Plasma Exchange
Purpura, Thrombotic Thrombocytopenic
Retinal Vein
Retinaldehyde
Thymine Nucleotides
Visual Acuity
Dacarbazine
Retinaldehyde
Thymine Nucleotides

Figure

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  Figure 1. Fundus photographs show dilated tortuous veins and diffuse retinal hemorrhages in the right eye (A) and left eye (B).

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  Figure 2. OCT shows macular edema in the right eye (A) and left eye (B).

Reference

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