Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disease which can initially present with predominant ocular symptoms. We report the case of a 21-year-old female patient with a complaint of acute onset of bilateral blurry vision. An eye exam showed a bilateral horizontal nystagm...

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Bibliographic Details
Main Authors: Iatissam El Belhadji, Adil Mchachi, Mohamed Elbelhadji
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-06-01
Series:The Pan-American Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/pajo.pajo_26_25
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Summary:Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disease which can initially present with predominant ocular symptoms. We report the case of a 21-year-old female patient with a complaint of acute onset of bilateral blurry vision. An eye exam showed a bilateral horizontal nystagmus, and her best-corrected visual acuity (BCVA) was hand movement. Fundus examination showed bilateral serous retinal detachment (SRD), and bilateral papillary edema. Retinal angiography and optical coherence tomography (OCT) later confirmed the SRD. She was diagnosed with TTP and was treated systemically with frozen plasma, oral prednisone, and calcium channel blockers. At her first follow-up visit, her BCVA had improved to 20/100; fundus examination and OCT confirmed the partial resolution of bilateral macular SRD. TTP should be considered in patients presenting with an association of SRD and any other ocular signs. Fast, appropriate systemic treatment is mandatory as it is a life-threatening disease, and to assure a satisfying visual outcome.
ISSN:2666-4909