Heparin-induced antiheparin-platelet antibody associated with retinal venous thrombosis

OBJECTIVE: To report a case of a 33-year-old white woman in whom retinal venous thromboses developed secondary to heparin-induced antiheparin-platelet antibodies. DESIGN: Interventional case report. METHODS: The patient underwent complete ophthalmic and medical examinations. Laser Doppler measurement of retinal blood circulation also was performed. INTERVENTION: Prolonged anticoagulation with thrombin inhibitors and warfarin. MAIN OUTCOME MEASURES: Visual symptoms, retinal appearance on clinical examination, and measurement of retinal blood flow by laser Doppler technique. RESULTS: The patient experienced a scotoma in the visual field of the left eye, left retinal venous thrombosis, decreased venous blood flow in the left eye, and heparin-induced antiheparin-platelet antibodies in serum. After intervention, the visual symptoms and retinal appearance improved, and retinal blood flow normalized. CONCLUSIONS: Heparin-induced antiheparin-platelet antibody can lead to thrombosis of the ocular circulation. This index case, which is the first one ever reported in association with antiheparin-platelet antibodies, further illustrates the potential side effects of heparin and widens the spectrum of complications of heparin-induced thrombocytopenia (HIT) and HIT thrombosis syndrome (HITTS).