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Case Reports
. 2021 Jul 1;15(4):482-485.
doi: 10.1097/ICB.0000000000000834.

BULL'S EYE MACULOPATHY POSSIBLY DUE TO IRON OVERLOAD IN A CHILD WITH THALASSEMIA MAJOR: A CASE OF POSSIBLE "FERRITIN RETINOPATHY"

Anina Abraham  1
Affiliations
Case Reports

BULL'S EYE MACULOPATHY POSSIBLY DUE TO IRON OVERLOAD IN A CHILD WITH THALASSEMIA MAJOR: A CASE OF POSSIBLE "FERRITIN RETINOPATHY"

Anina Abraham. Retin Cases Brief Rep. .

Abstract

Purpose: To report a case of bull's eye maculopathy probably caused by iron overload in a child with thalassemia major.

Methods: Case report.

Results: A 6-year-old girl with thalassemia major who was on chronic multiple blood transfusions since 2 years of age presented with blurred vision in both eyes for 2 months. Blood reports showed very high serum ferritin levels in the range 400 to 2,250 ng/mL (checked every 3 months) since 4 years of age. She was on oral iron chelator deferasirox for 2 years, which was stopped a month ago. Fundus examination of both eyes showed a characteristic bull's eye macula with a purplish hue in the outer ring probably due to iron deposition. The center of the bull's eye had a beaten bronze appearance.

Conclusion: Careful history-taking is important in children with bull's eye maculopathy because all such retinopathies need not be hereditary fundus dystrophies. Further progression can be arrested by identifying and removing the cause vision loss.

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Conflict of interest statement

The author has no financial/conflicting interests to disclose.

Figures

Fig. 1.
Fig. 1.
Fundus image of the right eye showing a purple-colored bull's eye maculopathy.
Fig. 2.
Fig. 2.
Fundus image of the left eye showing a purple-colored bull's eye maculopathy.
Fig. 3.
Fig. 3.
Optical coherence tomography of the right eye showing foveal and photoreceptor atrophy with underlying hyperreflectivity of the retinal pigment epithelium.
Fig. 4.
Fig. 4.
Optical coherence tomography of the left eye showing foveal thinning with underlying hyperreflectivity of the RPE.
See this image and copyright information in PMC

References

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Publication types

Supplementary concepts