Subhyaloid haemorrhage in a patient with vitamin B12 deficiency: a unique presentation

Abstract

Vitamin B12 deficiency causes pancytopenia and also is also assocciated with platelet dysfunction. We report the case of a 17-year-old girl, who presented with fatigue and sudden painless, non-progressive loss of vision in the left eye. An ophthalmologic evaluation revealed bilateral subhyaloid haemorrhage, with macular involvement on the left eye. Earlier Bone marrow aspiration and biopsy were suggestive of partially treated vitamin B12 deficiency with pancytopenia. The patient had received four doses of vitamin B12 injections. She was given a complete course of vitamin B12 injections. Both the pancytopenia and subhyaloid haemorrhage improved completely with restoration of normal vision. This case documents the rare occurrence of subhyaloid haemorrhage in vitamin B12 deficiency.

Keywords

• Retinal haemorrhage
• Megaloblastic anaemia
• Pure vegans
• Vitamin B12 deficiency