Mayer U. M.

Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Schwabachanlage 6, D 91054 Erlangen

Background: At the clinical diagnosis of thrombocytopenia the ophthalmologist usually sees hyposphagma or intraretinal hemorrhages. The described two patients showed quite different symptoms:
Casuistics: -First patient: a 48 year old man was known to suffer from thrombocytopenic purpura Moschcovitz since 15 years. One day before visiting our clinic he had blurred vision of his right eye. After correction by sph + 1,5, a deterioration of visual acuity was corrected to 0,8. The cause was to be seen in ophthalmoscopy: an oedema of central retina and choroid (photo). Because of danger of hemorrhage, we did no angiograms. Medical therapy and high doses of steroids declined a restitutio ad integrum within 10 days. -Second patient: a boy was born with bilateral intravitreal hemorrhages. By echography there was no tumor to be found (Echo). During the differentialdiagnostic examinations was registered an extreme thrombocytopenia. Being asked for several times, the mother told, that she had been treated for M.Werlhoff, but that she had been considered as to be healed, no pathologic finding had been noticed during pregnancy. Pediatric treatment brought normal findings . And the intravitreal hemorrhage resorbed very slowly. Finally, the child had bilateral atrophia bulbi and amaurosis (photo).
Conclusion: A well established interdisciplinary collaboration should be able to produce very early diagnoses and better treatment. There should be healing without sequelae like in our first patient.

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