Bilateral macular hemorrhage as a complication of drug-induced anemia: a case report.
BACKGROUND
Bilateral macular hemorrhage is a rare ocular finding and to the best of our knowledge, this is the first report of such hemorrhages as a presentation of drug-induced anemia.


METHODS
We describe the case of a 14-year-old Caucasian boy who presented with a toxoplasmic retinochoroiditis and was treated with sulfadiazine and pyrimethamine. Three months later, he presented with a bilateral macular hemorrhage as a complication of a toxic induced anemia.


CONCLUSIONS
Our patient presented with toxic anemia secondary to the treatment of a very common disease, ocular toxoplasmosis. Prophylactic use of folinic acid could prevent such complications but in many cases, it is not prescribed owing to its cost or is mistakenly substituted with folic acid, which does not present as a valid substitute.
Belfort
Rubens N
RN
Henry C Witelson Ocular Pathology Laboratory, Ophthalmology Department, McGill University, Montreal, QC, Canada. epm@belfort.med.br.
Fernandes
Bruno F
BF
Romano
André
A
Nose
Ricardo
R
Cools-Lartigue
Jonathan
J
Navajas
Eduardo V
EV
Vieira
Garles Mm
GM
Lopes
Renato Delascio
RD
Belfort
Rubens
R