J Korean Ophthalmol Soc.  2015 Aug;56(8):1284-1288. 10.3341/jkos.2015.56.8.1284.

Two Cases of Retinal Hemorrhage in Alcoholic Cirrhosis

• Kim YS
• Seo DR
• Han JW
• Park TK
• Ohn YH

• KMID: 2215084
• DOI: http://doi.org/10.3341/jkos.2015.56.8.1284

Abstract

PURPOSE
To report 2 cases of retinal hemorrhage due to anemia and thrombocytopenia in patients with alcoholic cirrhosis.
CASE SUMMARY
(Case 1) A 45-year-old female with alcoholic cirrhosis who was treated in the gastroenterology department presented with reduced vision in both eyes. Fundus examination showed multiple preretinal and subretinal hemorrhages with macular involvement in both eyes. Hematological findings revealed severe anemia and thrombocytopenia. One month after the transfusion treatment her visual acuity was improved and retinal hemorrhages resolved. (Case 2) A 47-year-old male presented with painless loss of vision in the left eye 3 days after orthotopic liver transplantation for the treatment of alcoholic cirrhosis. Fundus examination showed preretinal hemorrhages in both eyes with macular involvement in the left eye. During the transplantation, hematological findings revealed severe anemia and thrombocytopenia. Three months after the transfusion treatment his visual acuity was improved and retinal hemorrhages nearly completely resolved.
CONCLUSIONS
Hematological abnormalities due to alcoholic cirrhosis can cause retinal hemorrhage. In the present cases the retinal hemorrhages were resorbed and the visual acuity recovered.

Keyword

Alcoholic cirrhosis; Liver transplantation; Retinal hemorrhage

MeSH Terms

Alcoholics*
Anemia
Female
Gastroenterology
Hemorrhage
Humans
Liver Cirrhosis, Alcoholic*
Liver Transplantation
Male
Middle Aged
Retinal Hemorrhage*
Retinaldehyde*
Thrombocytopenia
Vision, Low
Visual Acuity
Retinaldehyde

Figure

• 

  Figure 1. Fundus photographs (A, B) and fluorescein angiography (C, D) finding of both eyes at initial visit. Fundus photographs show preretinal and subretinal hemorrhages. Fluorescein angiography show blocked fluo-resceins caused by retinal hemorrhages. Fundus photographs (E, F) at 1 month after the initial visit show reso-lution of hemorrhages.

• 

  Figure 2. Fundus photograph (A, B) of both eyes showing well-circumscribed preretinal hemorrhages, including a large premacular hemorrhage of the left eye. Arrow indicates optical coherence tomography scanning line shown in (C, D). Optical coherence tomography (C, D) of both eyes showing sub-internal limiting membrane hemorrhages. Fundus photograph (E, F) of both eyes at 3 months follow-up with nearly complete resolution of hemorrhages. Arrow indicates optical coherence tomography scanning line shown in (G, H). Optical coherence tomography (G, H) of both eyes at 3 months follow-up.

Reference

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