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Spontaneous bilateral peripapillary, subhyaloid and vitreous hemorrhage with only minor platelet deficit in idiopathic thrombocytopenic purpura

Authors Wan-Wei L, Tengku-Norina T, Azma-Azalina A, Abdul-Ghani Z, Zunaina E

Received 26 September 2013

Accepted for publication 4 November 2013

Published 24 January 2014 Volume 2014:7 Pages 15—17


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Loo Wan-Wei,1,2 Tuan-Jaffar Tengku-Norina,1 Ahmad-Alwi Azma-Azalina,1 Abdul-Ghani Zulkifli,1 Embong Zunaina2

Department of Ophthalmology, Hospital Raja Perempuan Zainab II, Kota Bharu, 2Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia

Abstract: A 45-year-old female with underlying idiopathic thrombocytopenic purpura (ITP) complained of acute onset of reduced vision and floaters, in both eyes, for 3 weeks. Visual acuity was 6/36 and 6/60 in the right eye and left eye, respectively. Ophthalmoscopy showed bilateral peripapillary, subhyaloid and vitreous hemorrhage. Hematological evaluation revealed moderate anemia (hemoglobin: 93 g/L) and mild thrombocytopenia (platelets: 120×109/L). She was co-managed by a hematologist and ophthalmologists; she was treated medically. Follow-up care during the next 6 weeks revealed spontaneous, partially resolving hemorrhage, with improvement of visual acuity. The purpose of this case report is to highlight ophthalmic involvement of ITP in this patient, despite her only-mild thrombocytopenia, and her spontaneous recovery, despite her receiving only medical treatment.

Keywords: idiopathic thrombocytopenic purpura, subhyaloid hemorrhage, vitreous hemorrhage

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