Aplastic anaemia presenting as pre retinal haemorrhage and roth spots - An interesting case report

A 45 yrs old female has come with the complaints of floaters in right eye since one week and defective vision in right eye since 4 days, sudden in onset, history of bleeding gums since 4 days. She gives history of giddiness, breathlessness, palpitations, easy fatiguability since 3 months. OE severe pallor , ocular examination showed Right eye pupil sluggishly reacting to light, BCVA was 3 by 60 NIPH, fundus RE- showed pre retinal haemorrhage in the macula extending upto the disc, with vitreous haemorrhage and multiple roth spots in the mid periphery. Fundus left eye showed multiple roth spots in the mid periphery. Lab investigations revealed pancytopenia and bone marrow study showed hypoplastic bone marrow and the diagnosis of apla tic anaemia made.she was treated with packed cell RBC's, platelets.