This medical case base journal introduced a case of aplastic anemia diagnosed during pregnancy, which developed bilateral disc edema and acute pre-retinal hemorrhage leading to vision loss. It happened on a 20 year old primigravid female, during hospitalization for treatment of aplastic anemia diagnosed during her pregnancy. Neuro-imaging studies did not reveal any signs of intracranial mass lession or edema.
A serious hematological disorder characterized by pancytopenia and hypoplastic bone marrow which often exacerbated during pregnancy is known as Aplastic Anemia. This condition is associated with hormonal imbalance between hematopoietic placental lactogen and erythropoetin and marrow suppressive estrogen.
As said in ths journal, aplastic anemia in a pregnant woman was firstly reported in 1888 and 78% of cases generate ophthalmic manifestations. In this case, vision loss happened after pre-retinal hemorrhage overlying the fovea in the right eye. And it can be a presenting syptom in previously undiagnosed cases of aplastic anemia. Thus, the hemorrhages due to anemia and thrombositopenia ha been assumed as part of retinal disorder in patients with anemic-thrombocytopenic retinopathy.
With increasing in intracranial pressure, optic disc edema has been reported to occur in 6% of aplastic anemia cases. In this case, the experts could not establish raised intracranial pressure as the cause for optic disc edema as the lumbar puncture resulted in a dry tap. As the level of hemoglobin stabilized, it gradually improved the patient’s edema and enlarged blind spot on HVF testing.
As summary, this medical journal described a case of visual loss due to pregnancy related aplastic anemia that was succesfully managed with supportive care including red blood cell and platelet transfussions.
The authors were Shailesh K Gupta, Vikram S Brar, Ravi Keshavamurthy, and Kakarla V Chalam from University of Florida-College of Medicine, Department of Ophthalmology, Jacksonville, Florida, USA. Read the Full Text Article or in its PDF Format. Thank you.
