Alluri Seetharamaraju Academy of Medical Sciences and Hospital, Eluru, West Godavari district, Andhra Pradesh, India.
Nepal J Ophthalmol. 2020 Jul;12(24):313-316. doi: 10.3126/nepjoph.v12i2.27209.
Anaemias are the commonest haematological disorders which cause ocular manifestations. With the progression of disease, retinal haemorrhages, dilated and tortuous veins, cotton wool spots may occur in the ocular fundus.
An 18-year-old female patient presented to our out patient department with the sudden, painless, non-progressive blurring of vision in both eyes (best-corrected visual acuity in the right eye is 6/60, and left eye is 6/36) for two days. On Ophthalmological examination, bilateral pale tarsal conjunctiva, yellowish discolouration of the sclera, hyperemic optic discs, macular haemorrhages, superficial and deep haemorrhages with Roth spots were observed. The haematological evaluation showed the presence of Megaloblastic anaemia (with haemoglobin - 2.5g%). There was severe pallor on general examination. Mild hepatomegaly and splenomegaly were noted on the systemic examination and confirmed by ultrasound abdomen. Intraocular pressure was 11 mmHg in both eyes.
This case documents the occurrence of bilateral macular haemorrhages and Roth spots in megaloblastic anaemia without thrombocytopenia. Other causes of Roth spots were excluded. Treatment of anaemia showed resolution of Roth spots.
贫血是最常见的血液系统疾病，可引起眼部表现。随着疾病的进展，眼底可能出现视网膜出血、扩张和扭曲的静脉、棉絮状斑点。
一名 18 岁女性患者因双眼突发性、无痛性、进行性视力模糊两天到我院门诊就诊（右眼最佳矫正视力为 6/60，左眼为 6/36）。眼科检查发现双侧苍白的睑结膜，巩膜发黄，充血的视盘，黄斑出血，浅层和深层出血伴 Roth 斑。血液学评估显示巨幼细胞性贫血（血红蛋白-2.5g%）。全身检查发现明显苍白，腹部超声证实轻度肝脾肿大。双眼眼压均为 11mmHg。
本例记录了巨幼细胞性贫血无血小板减少症患者双侧黄斑出血和 Roth 斑的发生。排除了 Roth 斑的其他原因。贫血的治疗显示 Roth 斑消退。
