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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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
Subjects:
Online Access:https://journals.lww.com/10.4103/pajo.pajo_26_25
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author Iatissam El Belhadji
Adil Mchachi
Mohamed Elbelhadji
author_facet Iatissam El Belhadji
Adil Mchachi
Mohamed Elbelhadji
author_sort Iatissam El Belhadji
collection DOAJ
description 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.
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issn 2666-4909
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publisher Wolters Kluwer Medknow Publications
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series The Pan-American Journal of Ophthalmology
spelling doaj-art-b5cc8c08807541e489fb2b111c6049172025-08-20T02:42:45ZengWolters Kluwer Medknow PublicationsThe Pan-American Journal of Ophthalmology2666-49092025-06-017116016010.4103/pajo.pajo_26_25Nystagmus as the presenting sign of thrombotic thrombocytopenic purpuraIatissam El BelhadjiAdil MchachiMohamed ElbelhadjiThrombotic 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.https://journals.lww.com/10.4103/pajo.pajo_26_25arterial hypertensionhypertensive retinopathynystagmusoptic neuritispapillary edemarenal failureretinal detachmentthrombotic microangiopathythrombotic thrombocytopenic purpura
spellingShingle Iatissam El Belhadji
Adil Mchachi
Mohamed Elbelhadji
Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
The Pan-American Journal of Ophthalmology
arterial hypertension
hypertensive retinopathy
nystagmus
optic neuritis
papillary edema
renal failure
retinal detachment
thrombotic microangiopathy
thrombotic thrombocytopenic purpura
title Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
title_full Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
title_fullStr Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
title_full_unstemmed Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
title_short Nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
title_sort nystagmus as the presenting sign of thrombotic thrombocytopenic purpura
topic arterial hypertension
hypertensive retinopathy
nystagmus
optic neuritis
papillary edema
renal failure
retinal detachment
thrombotic microangiopathy
thrombotic thrombocytopenic purpura
url https://journals.lww.com/10.4103/pajo.pajo_26_25
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AT adilmchachi nystagmusasthepresentingsignofthromboticthrombocytopenicpurpura
AT mohamedelbelhadji nystagmusasthepresentingsignofthromboticthrombocytopenicpurpura