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Published on: June 5, 2019
Heparin-induced antiheparin-platelet antibody associated with retinal venous thrombosis
Quan Dong Nguyen1, Diana Van Do, Gilbert T Feke
1Schepens Retina Associates Foundation, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA. qnguyen4@jhmi.edu
Objective:
To report a case of a 33-year-old white woman in whom retinal venous thromboses developed secondary to heparin-induced antiheparin-platelet antibodies.
Design:
Interventional case report.
Methods:
The patient underwent complete ophthalmic and medical examinations. Laser Doppler measurement of retinal blood circulation also was performed.
Intervention:
Prolonged anticoagulation with thrombin inhibitors and warfarin.
Main Outcome Measures:
Visual symptoms, retinal appearance on clinical examination, and measurement of retinal blood flow by laser Doppler technique.
Results:
The patient experienced a scotoma in the visual field of the left eye, left retinal venous thrombosis, decreased venous blood flow in the left eye, and heparin-induced antiheparin-platelet antibodies in serum. After intervention, the visual symptoms and retinal appearance improved, and retinal blood flow normalized.
Conclusions:
Heparin-induced antiheparin-platelet antibody can lead to thrombosis of the ocular circulation. This index case, which is the first one ever reported in association with antiheparin-platelet antibodies, further illustrates the potential side effects of heparin and widens the spectrum of complications of heparin-induced thrombocytopenia (HIT) and HIT thrombosis syndrome (HITTS).
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