title: Complete resorption of retinal hemorrhages in idiopathic thrombocytopenic purpura.
abstract: OBJECTIVE
  Idiopathic thrombocytopenic purpura (ITP) is characterized by refractory thrombocytopenia, production of autoantibodies, and persistent predisposition to bleeding affecting virtually all mucocutaneous tissues and various organs.
  
  
  METHODS
  A 50-year-old man with chronic ITP and diabetic maculopathy developed massive preretinal, intraretinal, and numerous subretinal hemorrhages accompanied by impaired vision to 20/400. His platelet count was 1100/microL, hemoglobin concentration was 4.6 mg/dL, however his blood clotting and activated partial thromboplastin time (APTT) maintained a normal 26 sec.
  
  
  RESULTS
  After a splenectomy the patient was placed on high-dose oral corticosteroids (40 mg/day), immunoglobulin, and CellCept. The platelet count was restored to 25,000/microL within months. Four months later the unaffected retina received a panretinal photocoagulation and intravitreal triamcinolone injection (25 mg). Two years after the thrombolytic event the hemorrhages resolved completely and the patient's vision recovered to 20/100.
  
  
  CONCLUSIONS
  Repetitive treatments with immunoglobulins and high-dose corticosteroids may increase the platelet count, inducing a complete resorption of the retinal hemorrhages and visual recovery during a long-term follow-up.
authors.affiliation: Department of Ophthalmology, University of Bonn, Bonn, Germany. meyer_eye@yahoo.com
authors.forename: C H
authors.initials: CH
authors.lastname: Meyer
authors.forename: J
authors.initials: J
authors.lastname: Callizo
authors.forename: S
authors.initials: S
authors.lastname: Mennel
authors.forename: J C
authors.initials: JC
authors.lastname: Schmidt
mesh_terms: D002908:Chronic Disease; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005938:Glucocorticoids / Q000008:administration & dosage; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013156:Splenectomy; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D006454:Hemoglobins; D014222:Triamcinolone Acetonide