ABSTRACT
Three patients with aplastic anemia were evaluated by the ophthalmology service within 2 months of the aplastic anemia diagnosis for bilateral visual loss. The mean age of diagnosis of aplastic anemia was 14.3 years (range: 5 to 19 years) and the mean follow-up was 25 months (range: 15 to 44 months). All 6 eyes demonstrated choroidal ischemia and vitreous hemorrhage. Pars plana vitrectomy was performed in four eyes of two patients for non-clearing vitreous hemorrhage; one patient was observed. Successful anatomic outcomes were achieved in 3 of 4 eyes that underwent vitrectomy. Initial visual acuity ranged from 20/80 to bare light perception and final visual acuity ranged from 20/20 to no light perception. All patients received immunosuppressive therapy including cyclosporine and anti-thymocyte globulin, and two underwent hematopoietic stem cell transplantation. All patients received perioperative platelet and blood transfusions. Pars plana vitrectomy resulted in functional and anatomic success in the majority of eyes in this series. Coordination of medical and surgical care with the hematology service is advisable to stabilize hematologic parameters prior to undertaking a vitreoretinal procedure.
AUTHORS
From the National Eye Institute (MA, SY, LJF, RJB, EYC, EDW), National Institutes of Health, Bethesda, Maryland; Retina Group of Washington (MML), Washington, DC; National Heart, Lung, Blood Institute (JP, PS), National Institutes of Health, Bethesda, Maryland; and Walter Reed Army Medical Center (EDW), Washington, DC.
Originally submitted June 16, 2009. Accepted for publication April 14, 2010. Posted online June 30, 2010.
Supported by intramural funding of the National Eye Institute and National Heart, Lung, Blood Institute, National Institutes of Health, Bethesda, Maryland.
Dr. Yeh has received support from the Heed Ophthalmic Foundation. The other authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Steven Yeh, MD, Casey Eye Institute, 3375 SW Terwilliger Blvd., Portland, OR 97239.
doi: 10.3928/15428877-20100625-04
