Picture Quiz Poll: A Pale Woman With Acute Vision

Information sourced from BMJ:

BMJ 2016;352:i1009
[Free full-text BMJ article PDF]

Minerva

Anaemic retinopathy

Koushik Tripathy, Rohan Chawla

koushiktripathy@gmail.com

A woman with aplastic anaemia presented with acute bilateral painless diminution of vision. Both eyes showed retinal venous dilatation, multiple intraretinal (superficial and deep) haemorrhages, preretinal haemorrhages, and Roth spots (white centred haemorrhages). Haemoglobin was 30 g/L (reference 120-158), total leucocyte count 3.5×109/L (3.5-9), platelet count 16×109/L (165-415). Haemorrhages at multiple levels in the fundus are seen in anaemia, especially when thrombocytopenia co-exists in diseases like aplastic anaemia and leukaemia. Preretinal haemorrhage in front of the fovea causes acute vision loss. Although sudden vision loss is alarming, referral to an ophthalmologist for fundus examination can avoid unnecessary investigations. Vision typically improves in 1-2 months with self resolution of haemorrhage and improvement of haemoglobin and platelet levels after the treatment of the primary disease.

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