Recurrent pre-retinal haemorrhages associated with coagulation factor VII deficiency

Area of Science:

• Ophthalmology
• Hematology

Background:

• Recurrent pre-retinal hemorrhages can cause sudden visual loss.
• Coagulation disorders are critical to diagnose for effective management.

Observation:

• A 20-year-old woman experienced sudden visual loss due to pre-retinal and vitreous hemorrhage.
• She later presented with sub-hyaloid pre-macular hemorrhage, treated with Nd-YAG laser hyaloidotomy.
• The patient also had a history of upper digestive tract hemorrhage and menorrhagia.

Findings:

• Hemostasis study revealed a rare deficiency in coagulation factor VII.
• This is the first reported association between factor VII deficiency and pre-retinal hemorrhages.

Implications:

• Highlights the need for comprehensive hemostasis evaluation in patients with unexplained recurrent hemorrhages, including ocular manifestations.
• Suggests that factor VII deficiency should be considered in the differential diagnosis of pre-retinal hemorrhages.
• Demonstrates successful management of pre-retinal hemorrhage via laser hyaloidotomy in the context of a bleeding disorder.