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Macular Hemorrhage in Pancytopenia (Colour Image, OCT)Systemerkrankungen -> Diseases of hematopoesis -> Erythropoesis -> Anemia30 years of age, female, VA 0.9 OD, 1.0 OS, IOP 16 mmHg OD, 17 mmHg OS.
Colour image of OD showing paramacular hemorrhage.
SD-OCT of OD revealing hemorrhage in the outer plexiform layer. The foveola remains uneffected.
The examination of blood cells showed a pancytopenia with leucocytopenia (2.900/microliter), anemia (hemoglobin 8.7 g/l), thrombocytopenia (41.000/microliter). A bone marrow biopsy was performed. The finding suggested a bone marrow aplasia (suspected myelodysplastic syndrome).
It was reported (1) that in adult acute leukaemia patients about 50% of those with macular haemorrhages developed intra-cranial haemorrhages, compared to 9% of those without macular haemorrhages (relative risk 5.0). Patients with macular haemorrhages should be monitored intensively for the development of intra-cranial haemorrhage, and receive priority in the allocation of platelets where these are in short supply.
Literature:
(1) Jackson N, Reddy SC, Harun MH, Quah SH, Low HC. Macular haemorrhage in adult acute leukaemia patients at presentation and the risk of subsequent intracranial haemorrhage. Br J Haematol. 1997 Jul;98(1):204-9. -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- |
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