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Serous Retinal Detachments in Thrombotic Thrombocytopenic Purpura

Serous Retinal Detachments in Thrombotic Thrombocytopenic Purpura Abstract • Serous retinal detachments are a rare ocular complication of thrombotic thrombocytopenic purpura (TTP), with only six previous case reports in the literature. We have recently observed two patients with relapsing TTP who developed bilateral serous retinal detachments during acute exacerbations of their disease. In contrast to all but one of the previously described patients, both of our patients survived the episode during which retinal detachments occurred. Hypertension appears to contribute to the development of retinal detachments in TTP, and vigorous efforts at blood pressure control are indicated. Serous retinal detachments may be a more frequent component of chronic relapsing TTP than has been suspected. References 1. Moschcowitz E: An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries: An undescribed disease . Arch Intern Med 1925;36:89-93.Crossref 2. Ridolfi RL, Bell WR: Thrombotic thrombocytopenic purpura: Report of 25 cases and review of the literature . Medicine 1981;60:413-428.Crossref 3. Amorosi EL, Ultman JE: Thrombotic thrombocytopenia purpura: Report of 16 cases and review of the literature . Medicine 1966; 45:139-159.Crossref 4. Percival SP: The eye and Moschcowitz's disease . Trans Ophthalmol Soc UK 1970;90:375-382. 5. Percival SP: Ocular findings in thrombotic thrombocytopenia purpura . Br J Ophthalmol 1970;54:73-78.Crossref 6. Clinicopathological conference . N Engl J Med 1963;269:1195-1203.Crossref 7. Clinicopathological conference . Mayo Clin Proc 1964;39:792-805. 8. Stefani FH, Brandt F, Pielsticker K: Periarteritis nodosa and thrombotic thrombocytopenia purpura with serous retinal detachments in siblings . Br J Ophthalmol 1978;62:402-407.Crossref 9. Benson DO, Fitzgibbons JF, Goodnight SH: The visual system in thrombotic thrombocytopenia purpura . Ann Ophthalmol 1980;12:413-417. 10. Coscas G, Gaudric A, Dhermy P, et al: Obstruction choriocapillaire au cours de la maladie de Moschcowitz . J Fr Ophtalmol 1981;4:101-111. 11. Jampol LM, Lahav M, Albert DM, et al: Ocular clinical findings and basement membrane changes in Goodpasture's syndrome . Am J Ophthalmol 1975;79:452-463. 12. Aronson AJ, Ordonez NG, Diddie KR, et al: Immune complex deposition in the eye in systemic lupus erythematosus . Arch Intern Med 1979; 139:1312-1313.Crossref 13. Jaben SL, Norton EW: Exudative retinal detachments in Wegener's granulomatosis: Case report . Ann Ophthalmol 1981;14:717-720. 14. Klein BA: Ischemic infarcts of the choroid (Elschnig spots): A cause of retinal separation in hypertensive disease with renal insufficiency: A clinical and histopathologic study . Am J Ophthalmol 1968;66:1069-1974. 15. Venicia G, Jampol LM: The eye in accelerated hypertension: II. Localized serous detachments of the retina in patients . Arch Ophthalmol 1984;102:68-73.Crossref 16. Cogan DG: Ocular involvement in disseminated intravascular coagulopathy . Arch Ophthalmol 1975;93:1-8.Crossref 17. Gitter KA, Houser BP, Sarin LK, et al: Toxemia of pregnancy: An angiographic interpretation of fundus changes . Arch Ophthalmol 1968;80:449-454.Crossref 18. Mabie WC, Ober RR: Fluorescein angiography in toxemia of pregnancy . Br J Ophthalmol 1980;64:666-671.Crossref 19. Fastenberg DM, Fetkenhour CL, Choromokos E, et al: Choroidal vascular changes in toxemia of pregnancy . Am J Ophthalmol 1980;89:362-368. 20. Frambach DA, Marmor MF: The rate and route of fluid resorption from the subretinal space of the rabbit . Invest Ophthalmol Vis Sci 1982;22:292-302. 21. Weiter JJ, Ernest JT: Anatomy of the choroidal vasculature . Am J Ophthalmol 1974; 78:583-590. 22. Hayreh SS: Segmental nature of the choroidal vasculature . Br J Ophthalmol 1975;59:631-648.Crossref 23. Stern WH, Ernest JT: Microsphere occlusion of the choriocapillaris in rhesus monkeys . Am J Ophthalmol 1974;78:438-448. 24. Moake JL, Rudy CK, Troll JH, et al: Unusually large plasma factor VIII: Von Willebrand factor multimers in chronic relapsing thrombotic thrombocytopenic purpura . N Engl J Med 1982; 307:1432-1435.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Serous Retinal Detachments in Thrombotic Thrombocytopenic Purpura

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1985.01050080084026
Publisher site
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Abstract

Abstract • Serous retinal detachments are a rare ocular complication of thrombotic thrombocytopenic purpura (TTP), with only six previous case reports in the literature. We have recently observed two patients with relapsing TTP who developed bilateral serous retinal detachments during acute exacerbations of their disease. In contrast to all but one of the previously described patients, both of our patients survived the episode during which retinal detachments occurred. Hypertension appears to contribute to the development of retinal detachments in TTP, and vigorous efforts at blood pressure control are indicated. Serous retinal detachments may be a more frequent component of chronic relapsing TTP than has been suspected. References 1. Moschcowitz E: An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries: An undescribed disease . Arch Intern Med 1925;36:89-93.Crossref 2. Ridolfi RL, Bell WR: Thrombotic thrombocytopenic purpura: Report of 25 cases and review of the literature . Medicine 1981;60:413-428.Crossref 3. Amorosi EL, Ultman JE: Thrombotic thrombocytopenia purpura: Report of 16 cases and review of the literature . Medicine 1966; 45:139-159.Crossref 4. Percival SP: The eye and Moschcowitz's disease . Trans Ophthalmol Soc UK 1970;90:375-382. 5. Percival SP: Ocular findings in thrombotic thrombocytopenia purpura . Br J Ophthalmol 1970;54:73-78.Crossref 6. Clinicopathological conference . N Engl J Med 1963;269:1195-1203.Crossref 7. Clinicopathological conference . Mayo Clin Proc 1964;39:792-805. 8. Stefani FH, Brandt F, Pielsticker K: Periarteritis nodosa and thrombotic thrombocytopenia purpura with serous retinal detachments in siblings . Br J Ophthalmol 1978;62:402-407.Crossref 9. Benson DO, Fitzgibbons JF, Goodnight SH: The visual system in thrombotic thrombocytopenia purpura . Ann Ophthalmol 1980;12:413-417. 10. Coscas G, Gaudric A, Dhermy P, et al: Obstruction choriocapillaire au cours de la maladie de Moschcowitz . J Fr Ophtalmol 1981;4:101-111. 11. Jampol LM, Lahav M, Albert DM, et al: Ocular clinical findings and basement membrane changes in Goodpasture's syndrome . Am J Ophthalmol 1975;79:452-463. 12. Aronson AJ, Ordonez NG, Diddie KR, et al: Immune complex deposition in the eye in systemic lupus erythematosus . Arch Intern Med 1979; 139:1312-1313.Crossref 13. Jaben SL, Norton EW: Exudative retinal detachments in Wegener's granulomatosis: Case report . Ann Ophthalmol 1981;14:717-720. 14. Klein BA: Ischemic infarcts of the choroid (Elschnig spots): A cause of retinal separation in hypertensive disease with renal insufficiency: A clinical and histopathologic study . Am J Ophthalmol 1968;66:1069-1974. 15. Venicia G, Jampol LM: The eye in accelerated hypertension: II. Localized serous detachments of the retina in patients . Arch Ophthalmol 1984;102:68-73.Crossref 16. Cogan DG: Ocular involvement in disseminated intravascular coagulopathy . Arch Ophthalmol 1975;93:1-8.Crossref 17. Gitter KA, Houser BP, Sarin LK, et al: Toxemia of pregnancy: An angiographic interpretation of fundus changes . Arch Ophthalmol 1968;80:449-454.Crossref 18. Mabie WC, Ober RR: Fluorescein angiography in toxemia of pregnancy . Br J Ophthalmol 1980;64:666-671.Crossref 19. Fastenberg DM, Fetkenhour CL, Choromokos E, et al: Choroidal vascular changes in toxemia of pregnancy . Am J Ophthalmol 1980;89:362-368. 20. Frambach DA, Marmor MF: The rate and route of fluid resorption from the subretinal space of the rabbit . Invest Ophthalmol Vis Sci 1982;22:292-302. 21. Weiter JJ, Ernest JT: Anatomy of the choroidal vasculature . Am J Ophthalmol 1974; 78:583-590. 22. Hayreh SS: Segmental nature of the choroidal vasculature . Br J Ophthalmol 1975;59:631-648.Crossref 23. Stern WH, Ernest JT: Microsphere occlusion of the choriocapillaris in rhesus monkeys . Am J Ophthalmol 1974;78:438-448. 24. Moake JL, Rudy CK, Troll JH, et al: Unusually large plasma factor VIII: Von Willebrand factor multimers in chronic relapsing thrombotic thrombocytopenic purpura . N Engl J Med 1982; 307:1432-1435.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1985

References