Two Cases of Retinal Hemorrhage in Alcoholic Cirrhosis

Kim Young Shin; Seo Du Ri; Jung Woo Han; Tae Kwann Park; Ohn Young-Hoon

doi:10.3341/jkos.2015.56.8.1284

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Young Shin, Du Ri, Han, Park, and Young-Hoon: Two Cases of Retinal Hemorrhage in Alcoholic Cirrhosis

Original Article

J Korean Ophthalmol Soc 2015;56(8):1284-1288.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.8.1284

Two Cases of Retinal Hemorrhage in Alcoholic Cirrhosis

Kim Young Shin, M.D¹, Seo Du Ri, M.D¹, Jung Woo Han, MD², Tae Kwann Park, MD, PhD², Ohn Young-Hoon, MD, PhD^2,

¹Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea

²Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

Address reprint requests to Young-Hoon Ohn, MD, PhD Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, #170 Jomaru-ro, Wonmi-gu, Bucheon 420-767, Korea Tel: 82-32-621-5425, Fax: 82-32-621-5435 E-mail: yhohn@schmc.ac.kr

∗ This study was presented as a poster at the 112th Annual Meeting of the Korean Ophthalmological Society 2014.

Received 21 November 201416 March 2015 Accepted 4 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report 2 cases of retinal hemorrhage due to anemia and thrombocytopenia in patients with alcoholic cirrhosis.

Case summary

(Case 1) A 45-year-old female with alcoholic cirrhosis who was treated in the gastroenterology department pre-sented with reduced vision in both eyes. Fundus examination showed multiple preretinal and subretinal hemorrhages with mac-ular involvement in both eyes. Hematological findings revealed severe anemia and thrombocytopenia. One month after the transfusion treatment her visual acuity was improved and retinal hemorrhages resolved. (Case 2) A 47-year-old male presented with painless loss of vision in the left eye 3 days after orthotopic liver transplantation for the treatment of alcoholic cirrhosis. Fundus examination showed preretinal hemorrhages in both eyes with macular involvement in the left eye. During the trans-plantation, hematological findings revealed severe anemia and thrombocytopenia. Three months after the transfusion treatment his visual acuity was improved and retinal hemorrhages nearly completely resolved.

Conclusions

Hematological abnormalities due to alcoholic cirrhosis can cause retinal hemorrhage. In the present cases the reti-nal hemorrhages were resorbed and the visual acuity recovered.

Keywords: Alcoholic cirrhosis, Liver transplantation, Retinal hemorrhage

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Figure 1.

Fundus photographs (A, B) and fluorescein angiography (C, D) finding of both eyes at initial visit. Fundus photographs show preretinal and subretinal hemorrhages. Fluorescein angiography show blocked fluo-resceins caused by retinal hemorrhages. Fundus photographs (E, F) at 1 month after the initial visit show reso-lution of hemorrhages.

Figure 2.

Fundus photograph (A, B) of both eyes showing well-circumscribed preretinal hemorrhages, including a large premacular hemorrhage of the left eye. Arrow indicates optical coherence tomography scanning line shown in (C, D). Optical coherence tomography (C, D) of both eyes showing sub-internal limiting membrane hemorrhages. Fundus photograph (E, F) of both eyes at 3 months follow-up with nearly complete resolution of hemorrhages. Arrow indicates optical coherence tomography scanning line shown in (G, H). Optical coherence tomography (G, H) of both eyes at 3 months follow-up.

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