warfarin and Scotoma

To report a case of a 33-year-old white woman in whom retinal venous thromboses developed secondary to heparin-induced antiheparin-platelet antibodies.. Interventional case report.. The patient underwent complete ophthalmic and medical examinations. Laser Doppler measurement of retinal blood circulation also was performed.. Prolonged anticoagulation with thrombin inhibitors and warfarin.. Visual symptoms, retinal appearance on clinical examination, and measurement of retinal blood flow by laser Doppler technique.. 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.. 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).

Topics: Adult; Anticoagulants; Autoantibodies; Female; Fluorescein Angiography; Heparin, Low-Molecular-Weight; Humans; Laser-Doppler Flowmetry; Platelet Factor 4; Regional Blood Flow; Retinal Vein Occlusion; Retinal Vessels; Scotoma; Thrombocytopenia; Warfarin

Topics: Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Female; Fundus Oculi; Humans; Middle Aged; Ophthalmoscopy; Scotoma; Visual Acuity; Warfarin

Episodic cerebro or retinovascular ischemic events without apparent cause occur in patients with cancer. We report a patient in remission from lymphoma whose multiple episodes of presumed ocular ischemia occurred in the setting of a circulating lupus anticoagulant. Symptoms resolved following therapy with Warfarin.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Brain; Cyclophosphamide; Dexamethasone; Doxorubicin; Humans; Hypertension; Ischemic Attack, Transient; Lupus Coagulation Inhibitor; Lymphoma, Large B-Cell, Diffuse; Magnetic Resonance Imaging; Male; Middle Aged; Remission Induction; Scotoma; Vincristine; Vision, Monocular; Warfarin

Episodic cerebro or retinovascular ischemic events without apparent cause occur in patients with cancer. We report a patient in remission from lymphoma whose multiple episodes of presumed ocular ischemia occurred in the setting of a circulating lupus anticoagulant. Symptoms resolved following therapy with Warfarin.

Topics: Antineoplastic Combined Chemotherapy Protocols; Eye; Humans; Ischemia; Lupus Coagulation Inhibitor; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Scotoma; Vision, Monocular; Warfarin