{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:47:14Z","timestamp":1777582034416,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report a case of pernicious anemia in a patient presenting with white-centered hemorrhages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Case report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 64-year-old man with uncontrolled hypertension, insulin-dependent type 2 diabetes, dyslipidemia, and diabetic retinopathy presented with significant bilateral visual acuity reduction. Ophthalmological examination revealed severe diabetic maculopathy, multiple peripapillary Roth spots and hemorrhages. Laboratory tests identified macrocytic anemia with severe vitamin B12 deficiency and an endoscopic biopsy of the gastric fundus led to the diagnosis of pernicious anemia. The patient received blood transfusion, vitamin B12 supplementation and underwent intravitreal anti-VEGF (aflibercept) injections and retinal panphotocoagulation. Over two months, the patient exhibited marked improvement in visual acuity and partial resolution of retinal abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Roth spots are a nonspecific sign that can be found in various pathologies, sometimes severe, such as pernicious anemia. In those cases, adequate vitamin B12 supplementation can resolve the signs and symptoms. Therefore, it is vital to carry out a comprehensive systemic etiological work-up to quickly treat the underlying cause, keeping in mind that multiple pathologies may coexist.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721251323306","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T02:35:43Z","timestamp":1742178943000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Roth spots revealing pernicious anemia in a diabetic patient"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1507-316X","authenticated-orcid":false,"given":"Victoria","family":"Marechal","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Centre Hospitalier Intercommunal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centre Hospitalier Intercommunal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilde M","family":"Goudot","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centre Hospitalier Intercommunal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania","family":"Lakraa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centre Hospitalier Intercommunal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Souied","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Centre Hospitalier Intercommunal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(80)35277-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(68)93098-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1113996"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000328123"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_2291_19"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_577_20"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.4066\/AMJ.2014.1872"},{"key":"e_1_3_2_9_2","first-page":"305","article-title":"Ocular findings in megaloblastic anemia associated with diabetes. A case report","volume":"83","author":"Hmaied W","year":"2005","unstructured":"Hmaied W, Ben Khalifa MM, Miled W, et al. Ocular findings in megaloblastic anemia associated with diabetes. A case report. Tunis M\u00e9d 2005; 83: 305\u2013307.","journal-title":"Tunis M\u00e9d"},{"key":"e_1_3_2_10_2","article-title":"Roth spots in pernicious anaemia","volume":"2011","author":"Macauley M","year":"2011","unstructured":"Macauley M, Nag S. Roth spots in pernicious anaemia. 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