Megaloblastic anemia may be associated with ophthalmologic changes.
Clinical symptoms may be absent or may include:
(1) intermittent blurring of vision
(2) reduced field of vision
Retinal exam:
(1) cotton wool spots
(2) retinal edema
(3) dilatation and tortuosity of retinal veins
(4) retinal hemorrhages
(5) macular hemorrhage
(6) Roth spots
(7) splinter and dot blot hemorhages
The changes are responsive to vitamin B12 and/or folate.
If the deficiency is severe and goes untreated, then the patient can develop permanent vision loss.
