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Case Reports: Unusual presentation of more common disease/injury
Case of unilateral anaemic retinopathy unmasking colorectal carcinoma
  1. Zhi Hong Toh,
  2. Chee Fang Chin and
  3. Nicola Yi’an Gan
  1. Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
  1. Correspondence to Dr Chee Fang Chin; chee_fang_chin{at}ttsh.com.sg; Dr Nicola Yi’an Gan; nicola_gan{at}ttsh.com.sg

Abstract

Anaemic retinopathy presents commonly with bilateral retinal haemorrhages and soft exudates. Unilateral optic disc oedema in these patients has rarely been mentioned. We report a case of an atypical presentation of anaemic retinopathy with recurrent unilateral optic disc oedema and retinal haemorrhages secondary to iron deficiency anaemia from a newly diagnosed colorectal adenocarcinoma.

A man in his 70s with multiple ischaemic risk factors was referred for unilateral optic disc oedema associated with a few retinal haemorrhages. Initial diagnosis was that of impending central retinal vein occlusion. The optic disc oedema initially resolved but recurred 8 months later with worsening unilateral disc oedema, ‘coin-shaped’ retinal haemorrhages, Roth’s spots and venous tortuosity. Full blood count showed microcytic hypochromic anaemia secondary to iron deficiency and colonoscopy revealed colorectal adenocarcinoma. The patient received blood transfusions, oral iron replacement and underwent surgical resection of the tumour. The anaemia resolved, and the fundus findings resolved as well.

  • retina
  • gastrointestinal surgery
  • haematology (incl blood transfusion)
  • colon cancer

https://doi.org/10.1136/bcr-2021-248029

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    Footnotes

    • CFC and NY’aG are joint senior authors.

    • Contributors ZHT was responsible for and contributed towards material preparation, taking consent from the patient, drafting of the initial manuscript and subsequent edits and updating of reference list. CFC and YNG reviewed and provided feedback throughout drafting of the manuscript. All authors have read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.