Pre-retinal haemorrhage: A complication of anemic retinopathy in a patient of microcytic hypochromic anemia

A 20-year old Indian female reported dimness of vision in both eyes since 5-6 days. Her best corrected visual acuity [BCVA] in right eye 6/24 (OD) and left eye 6/6 (OS). Anterior segment evaluation revealed conjunctival pallor. An ophthalmological evaluation revealed bilateral hyperemic disc with venous tortuosity and arterial attenuation, Roth spots in entire periphery in both eye. Pre-retinal haemorrhage over macula in right eye and flame shaped haemorrhage around macula in left eye.Hematological evaluation revealed the presence of anemia due to heavy blood loss in menstruation(with haemoglobin~2.1 gm%). General examination showed severe pallor. Other causes of anemia have been ruled out. She was treated with blood transfusion of four packed cell volume[PCV]. This case documents the rare occurrence of anemic retinopathy in patient of anemia due to menorrhagia. Keywords: Anemia, Anemic retinopathy, Menorrhagia, Preretinal haemorrhage, Roth spot.