Central retinal venous occlusion with co-existent thrombotic thrombocytopenic purpura and antiphospholipid syndrome

• central retinal venous occlusion
• thrombocytopenic purpura
• antiphospholipid syndrome

Central retinal venous occlusion usually occurs in elderly patients with known risk factors such as raised intraocular pressure, arterial hypertension, atherosclerotic disease, or diabetes mellitus. In addition, central retinal venous occlusion infrequently occurs in individuals with hyperviscosity from leukaemia, polycythaemia, Waldenstrom’s macroglobulinaemia, sickle cell disease, and periphlebitis.1 However, it has also been described in patients with antiphospholipid antibodies2 and rarely in patients with thrombotic thrombocytopenic purpura (TTP) (pentad of fever, microangiopathic haemolytic anaemia, thrombocytopenia, neurological abnormalities, and renal impairment).3 We describe central retinal venous occlusion in a 26 year old female patient with systemic lupus erythematous (SLE), in whom both TTP and antiphospholipid syndrome (APS) appear to have contributed to the pathogenesis. To our knowledge, co-existence of TTP and APS has not been previously reported in a case of central retinal venous occlusion.