Fundus autofluorescence and optical coherence tomography findings in thiamine responsive megaloblastic anemia

Retin Cases Brief Rep. 2015 Spring;9(2):114-6. doi: 10.1097/ICB.0000000000000106.

Abstract

Background: To report ophthalmologic fundus autofluorescence and spectral domain optical coherence tomography findings in a patient with thiamine responsive megaloblastic anemia (TRMA).

Methods: A 13-year-old girl with genetically proven TRMA was ophthalmologically (visual acuity, funduscopy, perimetry, electroretinogram) followed up over >5 years. Fundus imaging also included autofluorescence and spectral domain optical coherence tomography.

Results: During a 5-year follow-up, visual acuity and visual field decreased, despite a special TRMA diet. Funduscopy revealed bull's eye appearance, whereas fundus autofluorescence showed central and peripheral hyperfluorescence and perifoveal hypofluorescence. Spectral domain optical coherence tomography revealed affected inner segment ellipsoid band and irregularities in the retinal pigment epithelium and choroidea.

Conclusion: Autofluorescence and spectral domain optical coherence tomography findings in a patient with TRMA show retinitis pigmentosa-like retina, retinal pigment epithelium, and choroid alterations. These findings might progress even under special TRMA diet, indispensable to life. Ophthalmologist should consider TRMA in patients with deafness and ophthalmologic disorders.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anemia, Megaloblastic / complications*
  • Anemia, Megaloblastic / diagnosis
  • Anemia, Megaloblastic / drug therapy
  • Electroretinography
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Retinal Diseases / diagnosis*
  • Retinal Diseases / etiology
  • Retinal Diseases / physiopathology
  • Retinal Pigment Epithelium / drug effects
  • Retinal Pigment Epithelium / pathology*
  • Thiamine / therapeutic use*
  • Tomography, Optical Coherence / methods*
  • Visual Acuity
  • Visual Field Tests
  • Vitamin B Complex / therapeutic use

Substances

  • Vitamin B Complex
  • Thiamine