Massive choroidal hemorrhage associated with low molecular weight heparin therapy.
An 84-year-old woman with unstable angina pectoris was treated with subcutaneous enoxaparine (Clexane) for several days before presenting with severe pain and decreased vision in her left eye. The intraocular pressure was 70 mmHg, and fundus examination showed a pigmented choroidal lesion and associated choroidal and retinal detachment. Ultrasonography was consistent with choroidal hemorrhage, and she was diagnosed as having acute glaucoma secondary to massive subchoroidal hemorrhage. Medical control of the intraocular pressure resulted in a significant clinical improvement. Intraocular hemorrhage and angle-closure glaucoma are rare and previously unreported complications in patients treated with low molecular weight heparin. It is important to be aware of this ocular complication as these drugs are so often used.
Neudorfer
M
M
Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. meiraneu@netvision.net.il
Leibovitch
I
I
Goldstein
M
M
Loewenstein
A
A
D000086:Acetazolamide / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000188:drug therapy; D000925:Anticoagulants / Q000009:adverse effects*; D002832:Choroid Hemorrhage / Q000139:chemically induced* / Q000150:complications; D004359:Drug Therapy, Combination; D017984:Enoxaparin / Q000009:adverse effects*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000031:analogs & derivatives / Q000627:therapeutic use; D012163:Retinal Detachment / Q000209:etiology*
D000925:Anticoagulants; D017984:Enoxaparin; D005665:Furosemide; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate; D000086:Acetazolamide