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Case Reports
. 2017 May 6;2017:bcr2016218558.
doi: 10.1136/bcr-2016-218558.

You Are What You Eat: Ophthalmological Manifestations of Severe B 12 Deficiency

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Case Reports

You Are What You Eat: Ophthalmological Manifestations of Severe B 12 Deficiency

Cátia Azenha et al. BMJ Case Rep. .
Free PMC article

Abstract

Severe B12 vitamin deficiency due to diminished dietary intake is a known cause of severe pancytopenia with bleeding diathesis. The authors report a case with sudden-onset bilateral vision loss, severe pancytopenia and multiple organ failure secondary to B12 vitamin deficiency in a patient with a strict vegetarian diet. On funduscopic examination the patient had multiple bilateral exuberant haemorrhages in all retinal layers. Five months after presentation, he had a complete visual recovery without ophthalmological intervention.

Keywords: Haematology (incl blood transfusion); Malnutrition; Ophthalmology; Retina.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Colour fundus photograph of the right (A) and left eye (B) on presentation showing multiple haemorrhages and an extensive premacular retrohyaloidal haemorrhage with a blood–liquid gravitational level.
Figure 2
Figure 2
Colour fundus photographs (A,B,C) showing bilateral white centred retinal haemorrhages — Roth spots.
Figure 3
Figure 3
Colour fundus photograph (A,B) and red-free fundus photograph (C,D) 5 months after presentation showing subtle macular pigmentary changes and complete resolution of the haemorrhages.

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