Near-complete vision recovery from bilateral serous retinal detachment associated with thrombotic thrombocytopenic purpura

• Published in: BMJ case reports Vol. 15; no. 2; p. e244030
• Main Authors: Nguyen, Tran, Radhakrishnan, Saikripa M, Radhakrishnan, Srinidhi J, Johnson, David H
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 07.02.2022; BMJ Publishing Group
• Subjects: ADAMTS13 Protein; Anemia; Antibodies; Blood platelets; Case Report; Case reports; Cytotoxicity; Dehydrogenases; Diabetic retinopathy; Drug dosages; Hemoglobin; Hepatitis B; Humans; Immunotherapy; Laboratories; Lupus; Male; Middle Aged; Monoclonal antibodies; Mortality; Myopia; Ophthalmology; Pain; Patients; Plasma; Plasma Exchange; Purpura; Purpura, Thrombotic Thrombocytopenic - complications; Purpura, Thrombotic Thrombocytopenic - diagnosis; Purpura, Thrombotic Thrombocytopenic - therapy; Recovery (Medical); Remission (Medicine); Retinal detachment; Retinal Detachment - diagnosis; Retinal Detachment - etiology; Rituximab - therapeutic use; Thrombocytopenia; Thrombosis; retina; haematology (incl blood transfusion)
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-244030

Ocular manifestations of thrombotic thrombocytopenic purpura (TTP) are uncommon, and bilateral retinal detachment is a rare presentation of TTP. We report a rare case of bilateral retinal detachment from underlying TTP in a patient presenting with vision loss. A 56-year-old man presented with a 4-day history of bilateral vision loss. Bilateral serous retinal detachment was confirmed using dilated ophthalmoscope examination. Laboratory results were significant for severe thrombocytopenia, peripheral smear revealed numerous schistocytes and ADAMTS13 activity of less than 1%. The patient was treated with plasma exchange (PLEX), prednisone, rituximab and caplacizumab. This case report highlights that prompt treatment of TTP with PLEX, prednisone, rituximab and caplacizumab could result in significant vision recovery.