title: Bilateral CRAO and CRVO from thrombotic thrombocytopenic purpura: OCT findings and treatment with triamcinolone acetonide and bevacizumab.
abstract: A patient with thrombotic thrombocytopenic purpura secondary to adult-onset Still's disease presented with bilateral combined central retinal artery occlusion and central retinal vein occlusion, a rare complication reported only once before. Fundus appearance and fluorescein angiography were similar to the previous case. Optical coherence tomography findings demonstrated aspects consistent with both central retinal artery occlusion and central retinal vein occlusion. Treatment of one eye with intravitreal triamcinolone acetonide (4 mg) was not effective in improving visual acuity. Treatment of both eyes with intravitreal bevacizumab (1.25 mg) and panretinal photocoagulation was effective in eliminating iris neovascularization, although the patient lost all visual function.
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida 34102, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Schwartz
authors.forename: Marcela
authors.initials: M
authors.lastname: Hickey
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Puliafito
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D017075:Laser Coagulation; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications*; D015356:Retinal Artery Occlusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide