慢性难治性特发性血小板减少性紫癜患者双侧大量玻璃体视网膜出血

Massive bilateral vitreoretinal hemorrhage in patient with chronic refractory idiopathic thrombocytopenic purpura

Background: We describe a patient with chronic,refractory idiopathic thrombocytopenic purpura (ITP) who developed massive vitreoretinal hemorrhages in both eyes. Methods: A 49-year-old woman complained of an acute decrease of vision,and ophthalmoscopy revealed bilateral preretinal and subretinal hemorrhages around the optic disc. Her platelet counts were less than 5000/μ l in spite of repetitive administration of corticosteroids and immunoglobulins with splenectomy for the chronic refractory ITP. One month later,she developed massive vitreoretinal hemorrhages bilaterally,and vision decreased to hand-motion. Results: Vitrectomy was performed on both eyes after medical treatment to increase platelet counts. The intraretinal hemorrhages were absorbed from the area around the disc and vision recovered to 20/100 in the right eye and 20/2000 in the left after one month. Conclusion: Massive vitreoretinal hemorrhages can develop in patients with chronic refractory ITP,and vitrectomy can be beneficial for this condition.