Unilateral Anemic Retinopathy Mimicking Central Vein Occlusion in a Patient with Menorrhagia

Unilateral anemic retinopathy is an uncommon but reversible condition. A 43-year-old female presented with right eye blurring of vision for one week duration. She also had menorrhagia for a year. Examination showed visual acuity of counting fingers (right eye) and 6/6 (left eye). Right funduscopy showed optic disc swelling with retinal hemorrhages, cotton wool spots, Roth's spots, tortuous vessels and macular edema. The left fundus was normal. Systemic examination revealed severe pallor with presence of pansystolic murmur. The uterus was enlarged. Her hemoglobin level was 4.7g/dl while peripheral blood film revealed hypochromic microcytic anemia. Other blood parameters and counts were normal. Blood transfusion was performed and she underwent a myomectomy by the gynecologist. Her vision improved to 6/6 and the fundus lesions resolved within three weeks. This case highlights the uncommon findings of unilateral anemic retinopathy mimicking a central vein occlusion. Workup for this self-limiting condition should exclude lymphoproliferative malignancies and coagulopathies.