Thrombotic thrombocytopenic purpura (Moschcowitz's disease)

BACKGROUND: TTP is a rare haematological disease consisting of thrombocytopenia, haemolytic anaemia, fever, neurological symptoms and renal failure. PATIENT: A 63-year-old female patient presented to our clinic with bilateral progressive loss of visual acuity accompanied by metamorphopsia. Ophthalmoscopy revealed pigmentepithelial choroidal atrophy secondary to the occlusion of chorioidal vessels and disseminated intraretinal and diffuse vitreal haemorrhage. Fluorescein angiography showed an obvious hyperfluorescence in the areas of choroidal atrophy as well as perivascular leakage. The patient had a history of TTP, as diagnosed by internal medicine. CONCLUSION: Vascular damage in TTP is due to disseminated hyalin clots of fibrin platelets which aggregate in the small capillaries, caused by a disorder of the endothelium-thrombocyte interaction. When evaluating patients with occlusion areas of the choriocapillaris, Moschcowitz's disease should be taken into consideration even in elderly patients.