Why is their vision 20/200?

Tip #252


Here there is significant hyperrefloectivity in the inner retina. It is causing a dense shadow so that the ELM, EZ and RPE are obscured. The patient has bilateral hemorrhage and blockage of dye on angiography (see video discussion).

The patient was diagnosed with severe anemia.

In this tip's accompanying 7 min. video, we'll review:

  • The differential diagnosis of a homogeneous hyperreflective lesion in the inner retina.
  • How to interpret an angiogram with hypofluorescence
  • How anemia can affect the retina
Tip #252 Analysis


In a patient hyperreflectivity of the anterior retina always consider the possibility of anemia.

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