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Bilateral macular hemorrhage as a complication of drug-induced anemia: a case report
Rubens N Belfort1, Bruno F Fernandes, André Romano
1Henry C Witelson Ocular Pathology Laboratory, Ophthalmology Department, McGill University, Montreal, QC, Canada. epm@belfort.med.br.
Introduction:
Bilateral macular hemorrhage is a rare ocular finding and to the best of our knowledge, this is the first report of such hemorrhages as a presentation of drug-induced anemia.
Case Presentation:
We describe the case of a 14-year-old Caucasian boy who presented with a toxoplasmic retinochoroiditis and was treated with sulfadiazine and pyrimethamine. Three months later, he presented with a bilateral macular hemorrhage as a complication of a toxic induced anemia.
Conclusion:
Our patient presented with toxic anemia secondary to the treatment of a very common disease, ocular toxoplasmosis. Prophylactic use of folinic acid could prevent such complications but in many cases, it is not prescribed owing to its cost or is mistakenly substituted with folic acid, which does not present as a valid substitute.
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