Thrombocytopenia, anemia and retinal hemorrhage

This paper evaluates platelet abnormalities as factors in retinal hemorrhage. Sixty-seven patients, with platelet levels below 100,000 per mm³ or hemoglobin levels below 12 gm per 100 ml, or both, were examined ophthalmoscopically following mydriasis. In addition, records were reviewed or ophthalmoscopy was preformed on 123 patients with hemophilia and 42 patients with Cooley's anemia. When either anemia or thrombocytopenia alone is found, retinal hemorrhage is unlikely (0% in thrombocytopenia alone, 0% in Cooley's anemia and hemophilia, and 10% in anemia alone). When the two are combined, however, retinal hemorrhage is found in 44% of patients. When severe anemia is combined with severe thrombocytopenia, 70% of patients have ocular hemorrhage. The reasons for these findings are discussed. Retinal hemorrhage is much more likely to occur when anemia is accompanied by thrombocytopenia than when either is present alone.