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OPHTHALMIC IMAGE
Year : 2020  |  Volume : 68  |  Issue : 10  |  Page : 2265

Bilateral macular Roth spots as a rare manifestation of hemoglobin E trait


1 Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
2 Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
3 Department of Vitreo-Retina Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India

Date of Web Publication23-Sep-2020

Correspondence Address:
Dr. Saurabh Deshmukh
Sri Sankaradeva Nethralaya, 96, Beltola, Guwahati - 781 028, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2176_19

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How to cite this article:
Gupta K, Das D, Deshmukh S. Bilateral macular Roth spots as a rare manifestation of hemoglobin E trait. Indian J Ophthalmol 2020;68:2265

How to cite this URL:
Gupta K, Das D, Deshmukh S. Bilateral macular Roth spots as a rare manifestation of hemoglobin E trait. Indian J Ophthalmol [serial online] 2020 [cited 2020 Nov 26];68:2265. Available from: https://www.ijo.in/text.asp?2020/68/10/2265/295705



A 13-year-old-male child presented for diminution of vision in left eye (OS). Vision was 20/20 in right eye (OD) and 20/200 OS. Fundus examination showed two Roth spots in macular region OD and one large Roth spot in the macular region involving fovea OS [Figure 1]a and [Figure 1]b. He had mild pallor. Hematological examination showed low hemoglobin and red cell indices, normal RBC count, platelet count, total leucocyte count, and differential leucocyte count. Blood smear showed anisopoikilocytosis, hypochromia, and microcytes [Figure 1]c. High-performance liquid chromatography (HPLC) showed Hb E (same elution as Hb A2) 32.5% [Figure 1]d. Hematological and HPLC findings confirmed the diagnosis of Hb E trait. Patient was treated with oral folic acid for anemia and at 6-month follow-up, Roth spots resolved and vision improved to 20/40 OS.
Figure 1: Color fundus photograph of the (a) right eye showing multiple white-centered hemorrhages in the macular area, and (b) left eye showing a single large Roth spot involving the fovea. (c) Blood smear showing hypochromia and microcytes. (d) HPLC tracing showing findings diagnostic of Hb E trait; Hb A0 61.3%, Hb A2 (Hb E) 29.1%. (On HPLC, the elution time of Hb A2 and Hb E is same)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Acknowledgements

We would like to thank Sri Kanchi Sankara Health and Educational Foundation, Guwahati, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




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