Massive bilateral vitreoretinal hemorrhage in patient with chronic refractory idiopathic thrombocytopenic purpura.
BACKGROUND
We describe a patient with chronic, refractory idiopathic thrombocytopenic purpura (ITP) who developed massive vitreoretinal hemorrhages in both eyes.


METHODS
A 49-year-old woman complained of an acute decrease of vision, and ophthalmoscopy revealed bilateral preretinal and subretinal hemorrhages around the optic disc. Her platelet counts were less than 5000/mul in spite of repetitive administration of corticosteroids and immunoglobulins with splenectomy for the chronic refractory ITP. One month later, she developed massive vitreoretinal hemorrhages bilaterally, and vision decreased to hand-motion.


RESULTS
Vitrectomy was performed on both eyes after medical treatment to increase platelet counts. The intraretinal hemorrhages were absorbed from the area around the disc and vision recovered to 20/100 in the right eye and 20/2000 in the left after one month.


CONCLUSIONS
Massive vitreoretinal hemorrhages can develop in patients with chronic refractory ITP, and vitrectomy can be beneficial for this condition.
Okuda
Amy
A
Department of Ophthalmology, Keio University of School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan.
Inoue
Makoto
M
Shinoda
Kei
K
Tsubota
Kazuo
K
D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D009887:Ophthalmoscopy; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000175:diagnosis; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery