Phlebotomy improved vision

<<snip>>
due to the great viscosity of blood
<<snip>>

J Neurol Sci. 2007 Apr 25; [Epub ahead of print] Links
Isolated monocular visual loss as an initial manifestation of
polycythemia vera.Ahn BY, Choi KD, Choi YJ, Jea SY, Lee JE.
Department of Neurology, Pusan National University Hospital, Pusan
National University School of Medicine and Medical Research Institute,
Republic of Korea.

A 25-year-old man developed prolonged loss of vision in the left eye.
Examination revealed that visual acuity was 20/20 in the right eye and
10/20 in the left eye, with a left relative afferent pupillary defect.
Fundoscopy showed multiple cotton wool spots in the left whole retina
with normal optic disc. Fluorescein angiography (FA) revealed markedly
delayed arterial, venous and recirculation time in the left eye
without retinal arterial or venous occlusion. Bone marrow aspirate
confirmed polycythemia vera. After the patient underwent phlebotomy,
his visual acuity markedly improved and cotton wool spots in the
retina disappeared. On follow-up FA, delayed arterial and venous
filling, and recirculation time also became normalized. This case
suggests that ischemic damage of the retina due to the great viscosity
of blood may be a possible mechanism of monocular visual loss in
polycythemia vera. Clinicians should be aware that isolated monocular
visual loss may be an initial manifestation of polycythemia vera,
since if untreated, polycythemia vera carries a high risk of permanent
complications due to intravascular thrombosis.

PMID: 17466335 [PubMed - as supplied by publisher]


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