Bilateral macular Roth spots as a rare manifestation of hemoglobin E trait
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 [Fig. 1a and 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 [Fig. 1c]. High-performance liquid chromatography (HPLC) showed Hb E (same elution as Hb A2) 32.5% [Fig. 1d]. 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.
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We would like to thank Sri Kanchi Sankara Health and Educational Foundation, Guwahati, India.© 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow