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Lee and Oh: Anemic Retinopathy after Chemotherapy
Case Report

Journal of the Korean Ophthalmological Society 2019; 60(12): 1352-1355.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1352

Anemic Retinopathy after Chemotherapy

Seung Chan Lee, MD, Baek Lok Oh, MD

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Address reprint requests to Baek Lok Oh, MD. Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: 82-2-2072-3740, Fax: 82-2-741-3187, baeklok@snu.ac.kr

Received 26 July 2019       Revised 19 September 2019       Accepted 29 November 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

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 a case of anemic retinopathy after chemotherapy.

Case summary

A 32-year-old male presented with visual disturbance in both eyes. He had been diagnosed with testicular cancer and had undergone right orchiectomy 4 months prior. He completed adjuvant chemotherapy 2 weeks before presentation. His best-corrected visual acuities were 20/35 in both eyes. Fundus examination revealed multiple flame-shaped hemorrhages around the posterior pole, and boat-shaped hemorrhages on the macula in both eyes. Laboratory results showed that he had reduced hemoglobin (5.5 g/dL) and platelet counts (77,000/µL). After transfusion, visual acuities were improved and retinal hemorrhages were resolved along with normalization of the hematological conditions.

Conclusions

Many ocular and medical conditions can cause bilateral retinal hemorrhages. This case emphasizes that comprehensive history evaluation, systemic evaluation, and laboratory findings, as well as a detailed fundus examination, are important in the diagnosis of patients with bilateral retinal hemorrhages.

Keywords: Anemia, Retinal hemorrhage, Thrombocytopenia

Figures and Tables

Figure 1

Fundus photographs at the initial presentation (A, B), at 1 month follow-up visit (C, D) and at 3 months follow-up visit (E, F). Fundus examination revealed multiple flame-shaped hemorrhages at the posterior pole in both eyes and premacular boat-shaped hemorrhage in the left eye (A, B). Retinal hemorrhages almost resolved in the right eye and small residual premacular hemorrhage remained in the left eye (E, F).

jkos-60-1352-g001
Figure 2

Spectral domain-optical coherence tomography (SD-OCT) images at the initial presentation (A, B), at 1 month follow-up visit (C, D) and at 3 months follow-up visit (E, F). Vertical macular scans of SD-OCT demonstrated premacular sub-internal limiting membrane (ILM) hemorrhage and multiple intra-retinal nerve fiber layer hemorrhage in both eyes. There was no definite outer retinal abnormality except optical shadowing effect due to hemorrhage (A, B). Vertical scans of SD-OCT demonstrated a small amount of sub-ILM hemorrhage on the macula in both eyes (E, F).

jkos-60-1352-g002

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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