Aplastic anemia presenting with bilateral, symmetric preretinal macular hemorrhages

Lee, Andrew R.; Bhullar, Paramjit K; Fekrat, Sharon

doi:10.1016/j.jcjo.2016.05.016

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…1 Bentuk perdarahan ini sangat khas yaitu berbentuk kubah dengan darah di antara membran limitans interna dan membran hialoid. 2,3 Kondisi ini dapat terjadi karena kelainan darah dan pembuluh darah seperti leukemia, 4 anemia aplastik, 5,6 oklusi pembuluh darah vena retina, 7 microanerusisma, 8 penyakit neovaskularisasi seperti proliferative diabetic retinopathy, atau karena peningkatan tekanan yang mendadak seperti akibat batuk atau Valsava maneuver. 9,10 Perdarahan retina merupakan salah satu temuan yang paling sering pada pasien dengan leukemia.…”

Section: Pendahuluanunclassified

Nd:YAG Laser Hialoidotomi sebagai Tatalaksana Perdarahan Premakular Subhialoid pada Pasien Leukemia Anak: Laporan Kasus

Nursalim,

Sumual,

Citra

et al. 2023

eCl

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Premacular subhyaloid is a condition that results in a severe decrease in visual acuity, especially if it occurs in the area around the macula. This subhyaloid premacular hemorrages often occurs in acute lymphoblastic leukemia. Nd:YAG laser hyaloidotomy is a non-invasive therapy option to treat this condition. We reported a case of a 15-year-old boy who came with a complaint of blurred right eye. The patient had a history of acute lymphoblastic leukemia. Visual acuity was 1/60 in the right eye and 6/9 in the left eye. A dome-shaped subhyaloid hemorrhage was found in the right eye and then was treated with Nd:YAG laser hyaloidotomy. The results of therapy were seen in improvement of vision after one week of therapy. In conclusion, Nd:YAG laser hyaloidotomy is a non-invasive procedure that is relatively safe, and improvement of vision can be observed in a short time, in this case, within one week. Keywords: Nd:YAG laser; hyaloidotomy; subhyaloid premacular hemorrages; acute lymphoblastic leukemia Abstrak: Perdarahan premakular subhialoid merupakan kondisi yang mengakibatkan turunnya tajam penglihatan yang hebat terutama jika terjadi di daerah sekitar makula. Perdarahan premakular subhialoid ini sering terjadi pada leukemia limfoblastik akut. Nd:YAG laser hialoidotomi merupakan salah satu terapi non invasif untuk mengatasi keadaan perdarahan ini. Kami melaporkan kasus seorang anak laki-laki berusia 15 tahun dengan keluhan mata kanan kabur mendadak. Pasien dengan riwayat leukemia limfoblastik akut. Tajam penglihatan 1/60 pada mata kanan dan 6/9 pada mata kiri. Ditemukan perdarahan subhialoid berbentuk kubah pada mata kanan dan dilakukan terapi Nd:YAG laser hialoidotomi. Hasil terapi memperlihatkan perbaikan tajam penglihatan setelah satu minggu terapi. Simpulan kasus ini ialah terapi Nd:YAG laser hialoidotomi merupakan prosedur non- invasif yang relatif aman dan perbaikan tajam penglihatan dapat terlihat dalam waktu singkat yaitu dalam kurun waktu satu minggu Kata kunci: Nd:YAG laser hialoidotomi; perdarahan premakular subhialoid; leukemia limfoblastik akut

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Section: Pendahuluanunclassified

Nd:YAG Laser Hialoidotomi sebagai Tatalaksana Perdarahan Premakular Subhialoid pada Pasien Leukemia Anak: Laporan Kasus

Nursalim,

Sumual,

Citra

et al. 2023

eCl

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“…Retinopathy was observed in 69% of aplastic anaemia patients who showed an Hb <80 g/L and platelet counts of <50×10 9 /L 3. They may present with retinal and vitreous haemorrhages, cotton wool spots, central retinal venous occlusion-like, optic disc oedema, macular oedema, peripheral retinal vasculopathy, orbital and lid hematomas 4–6. Blood turbulence, endothelial injury and bleeding diathesis have been shown to contribute to the occurrence of these haemorrhages 4.…”

Section: Descriptionmentioning

confidence: 99%

Retinopathy in severe aplastic anaemia

et al. 2019

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Figure 1 Montage fundus images. (A) Right eye and (B) left eye, showing extensive preretinal, intraretinal and subretinal haemorrhages, numerous Roth spots (white arrows), neurosensory detachments (black *) and masses of organising haemorrhages (black arrows).Figure 2 Macular optical coherence tomography images. (A) Right eye and (B) left eye, showing subinternal limiting membrane bleeds, hyper-reflective inner retinal layers, intraretinal cystic spaces and neurosensory detachments (white *). Dense haemorrhage (white arrow) blocking the visibility of underlying structures in the left eye. Learning points► Anaemic retinopathy is fairly common, especially when the haemoglobin levels are <8 g%. ► Anaemia and thrombocytopaenia in the setting of aplastic anaemia can be potentially blinding. ► Blood turbulence, endothelial injury and bleeding diathesis have been shown to contribute to the occurrence of haemorrhages in aplastic anaemia. DesCripTionA 19-year-old girl presented to the emergency services with complaints of haematuria, gum bleeding and sudden visual loss. General examination revealed significant pallor and multiple petechiae all over the body. Her heart rate was 98 beats/min, blood pressure 102/58 mm Hg, respiratory rate 18 breaths/min and SpO2 99%. The best corrected visual acuity was counting fingers at 2 m in the right eye and at 1 m in left eye. The anterior segment of both eyes (BE) was within normal limits. On dilated fundus examination, BE showed extensive preretinal, intraretinal and subretinal haemorrhages, numerous Roth spots, hard exudates and masses of organising haemorrhages (figure 1). Macular optical coherence tomography showed BE subinternal limiting membrane bleeds, intraretinal oedema and neurosensory detachments (figure 2). On investigating, her haemoglobin (Hb) was 28 g/L, haematocrit 8.2%, platelet count 1000/mm 3 and leucocyte count 2.2×10 9 /L. She was referred to a haematologist for detailed evaluation and advised to refrain from eye rubbing, Valsalva manoeuvres and vigorous activities. Bone marrow examination revealed pancytopaenia with a hypocellular marrow. A diagnosis of aplastic anaemia with anaemic retinopathy was made and treated with packed red blood cells and platelet rich plasma.Anaemic retinopathy is fairly common, especially when the Hb levels are <80 g/L. 1 In the presence of anaemia and/or thrombocytopaenia, the prevalence of retinopathy was found to be 28.3%, which further rose to 38% when both the conditions coexisted. 2 Nevertheless, in view of its subtle nature not affecting the visual acuity, it frequently remains undetected or under diagnosed. Ironically, anaemia and thrombocytopaenia in the setting of aplastic anaemia can be potentially blinding. Retinopathy was observed in 69% of aplastic anaemia patients who showed an Hb <80 g/L and platelet counts of <50×10 9 /L. 3 They may present with retinal and vitreous haemorrhages, cotton wool spots, central retinal venous occlusion-like, optic disc oedema, macular oedema, peripheral retinal vasculopathy, orbital and lid...

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“…A 36-year-old male revealed pancytopenia on complete blood count: (white blood cells [WBC] 1.72, [normal 5.5–15.5 10 9 /L]; platlets: 14.36, [normal: 150–450 10 9 /L]; red blood cells [RBC]: 3.25 [normal: 4.10–5.40 10 12 /L], and hemoglobin [Hb]: 9.7 [normal: 11.0–14.5 g/dl]) and marked hypocellularity on bone marrow biopsy, finally established a diagnosis of aplastic anemia of unknown etiology. Aplastic anemia is an autoimmune disorder of bone marrow stem cells caused by viruses, drugs, irradiation, or inherited disease like Fanconi anemia,[ 1 ] leading to pancytopenia and hypoplastic marrow that presents with anemia, infection, or bleeding and potentially life-threatening[ 2 ] and may present with sudden visual loss due to vitreous, preretinal, and retinal hemorrhages develop due to blood turbulence, endothelial damage, and bleeding diathesis[ 3 ] and optic disc edema. [ 4 ]…”

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confidence: 99%

Spontaneously resolved severe retinopathy associated with aplastic anemia

Mal

Abri

2021

Oman J Ophthalmol

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Aplastic anemia is a rare, usually autoimmune disorder of bone marrow stem cells leading to pancytopenia and hypoplastic marrow that presents with anemia, infection or bleeding which can be potentially sight and life-threatening. Patients with aplastic anemia may present with various ocular manifestations; lid and orbital hematoma, sub-conjunctival hemorrhage, sudden visual loss due to vitreous hemorrhage or retinopathy and optic disc edema. A young male patient had symptomatic sever bilateral hemorrhagic retinopathy secondary to aplastic anemia; succeeding systemic allogenic hematopoietic stem-cell transplantation showed almost complete spontaneous resolution of the retinopathy and significant improvement in vision over a period of 16 weeks.

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Aplastic anemia presenting with bilateral, symmetric preretinal macular hemorrhages

Cited by 6 publications

References 4 publications

Nd:YAG Laser Hialoidotomi sebagai Tatalaksana Perdarahan Premakular Subhialoid pada Pasien Leukemia Anak: Laporan Kasus

Nd:YAG Laser Hialoidotomi sebagai Tatalaksana Perdarahan Premakular Subhialoid pada Pasien Leukemia Anak: Laporan Kasus

Retinopathy in severe aplastic anaemia

Spontaneously resolved severe retinopathy associated with aplastic anemia

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