Heparin-induced antiheparin-platelet antibody associated with retinal venous thrombosis.
OBJECTIVE
To report a case of a 33-year-old white woman in whom retinal venous thromboses developed secondary to heparin-induced antiheparin-platelet antibodies.


METHODS
Interventional case report.


METHODS
The patient underwent complete ophthalmic and medical examinations. Laser Doppler measurement of retinal blood circulation also was performed.


METHODS
Prolonged anticoagulation with thrombin inhibitors and warfarin.


METHODS
Visual symptoms, retinal appearance on clinical examination, and measurement of retinal blood flow by laser Doppler technique.


RESULTS
The patient experienced a scotoma in the visual field of the left eye, left retinal venous thrombosis, decreased venous blood flow in the left eye, and heparin-induced antiheparin-platelet antibodies in serum. After intervention, the visual symptoms and retinal appearance improved, and retinal blood flow normalized.


CONCLUSIONS
Heparin-induced antiheparin-platelet antibody can lead to thrombosis of the ocular circulation. This index case, which is the first one ever reported in association with antiheparin-platelet antibodies, further illustrates the potential side effects of heparin and widens the spectrum of complications of heparin-induced thrombocytopenia (HIT) and HIT thrombosis syndrome (HITTS).
Nguyen
Quan Dong
QD
Schepens Retina Associates Foundation, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA. qnguyen4@jhmi.edu
Van Do
Diana
D
Feke
Gilbert T
GT
Demirjian
Zareh Nazareth
ZN
Lashkari
Kameran
K
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001323:Autoantibodies / Q000009:adverse effects*; D005260:Female; D005451:Fluorescein Angiography; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D010978:Platelet Factor 4 / Q000276:immunology*; D012039:Regional Blood Flow; D012170:Retinal Vein Occlusion / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D012171:Retinal Vessels / Q000502:physiology; D012607:Scotoma; D013921:Thrombocytopenia / Q000139:chemically induced*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D001323:Autoantibodies; D006495:Heparin, Low-Molecular-Weight; D010978:Platelet Factor 4; D014859:Warfarin