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KMID : 0360220210620040583
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Journal of the Korean Ophthalmological Society
2021 Volume.62 No. 4 p.583 ~ p.587
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Massive Retinal Hemorrhage during Epiretinal Membrane Peeling in Patient with Iron Deficiency Anemia
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Wang Li-Lyung
Yang Ji-Ho
Kim Do-Gyun
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Abstract
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Purpose: To report a case of massive retinal hemorrhage during epiretinal membrane (ERM) peeling in a patient with iron deficiencyanemia (IDA).
Case summary: A 59-year-old female presented with gradually decreasing visual acuity and dysmorphopsia in the right eye forseveral months. She had a history of chronic IDA due to subtotal gastrectomy from gastric cancer 20 years prior. The patient wasdiagnosed as having macular ERM and underwent vitrectomy. During ERM peeling with intraocular forceps, we found a massiveretinal hemorrhage which was presumed to have originated from the superotemporal branched retinal artery. After hemostasis,the operation was completed without critical complications. However, 2 months after surgery, the patient presented with decreasedvisual acuity once again. In fundus examination, diffuse macular tractional ERM was evident in the proximity of the previousintraoperative hemorrhage site. The patient underwent tractional membrane and internal limiting membrane removalsurgery. The patient is currently undergoing follow-up without complications to date following the second surgery.
Conclusions: Our case study describes a patient having experienced massive retinal hemorrhage presumably having originatedfrom a superotemporal branched retinal artery during ERM peeling. We speculate that the endothelial cells of retinal vessels aremore vulnerable than normal in patients with severe chronic IDA.
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KEYWORD
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Epiretinal membrane peeling, Iron deficiency anemia, Retinal hemorrhage
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