An Unusual Case of Anaemic Retinopathy Secondary to Iron Deficiency Anaemia

Abstract

Anaemia has varied ocular presentations, ranging from simple conjunctival pallor to retinal abnormalities. Anaemic Retinopathy (AR) is a secondary retinal pathological symptom that can range from asymptomatic to developing retinal abnormalities. The increase in the severity of anaemia will ultimately increase the risk of retinopathy. While the outcomes might be similar to hypertensive or diabetic retinopathy, further comprehensive systemic and clinical evaluation is warranted. The incidence of AR, its associations with varying degrees of anaemia severity, and other haematological variables is still debated. Visual loss due to retinal abnormalities in anaemia is a rare clinical entity, despite its long-standing existence. Hereby, the authors present a case of a patient presenting with AR. A 19-year-old woman with a history of heavy menstrual bleeding was admitted for a sudden, painless, non progressive loss of vision in her left eye. Upon examination, her fundus revealed several Roth spots affecting all four quadrants and the macula, alongside a large and small preretinal haemorrhage in the nasal region and in the macula. Blood investigations revealed a Haemoglobin (Hb) of 2.4 g/dL and other reports suggestive of iron deficiency. She was diagnosed with iron-deficiency anaemia, with retinopathy as the most remarkable feature. She was treated with blood transfusion and Iron-folic Acid (IFA) supplementation, which showed a prompt response in the resolution of haemorrhage. She was discharged on IFA supplementation with planned follow-up for Ophthalmology and Gynaecology visits along with dietary advice.