title: Heparin-induced antiheparin-platelet antibody associated with retinal venous thrombosis.
abstract: 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).
authors.affiliation: Schepens Retina Associates Foundation, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA. qnguyen4@jhmi.edu
authors.forename: Quan Dong
authors.initials: QD
authors.lastname: Nguyen
authors.forename: Diana
authors.initials: D
authors.lastname: Van Do
authors.forename: Gilbert T
authors.initials: GT
authors.lastname: Feke
authors.forename: Zareh Nazareth
authors.initials: ZN
authors.lastname: Demirjian
authors.forename: Kameran
authors.initials: K
authors.lastname: Lashkari
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D001323:Autoantibodies; D006495:Heparin, Low-Molecular-Weight; D010978:Platelet Factor 4; D014859:Warfarin