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A 38-year-old man with bilateral foveal hemorrhages
Digital Journal of Ophthalmology 2008
Volume 14, Number 7
March 11, 2008
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Ian Yeung | Southampton General Hospital, UK
Conor Mulholland | The Royal Victoria Hospital, Belfast
Differential Diagnosis
In this case the history points clearly to the diagnosis discussed below. However, on the basis of the fundus appearance alone, the differential diagnosis might include other retinopathies, in particular those listed below.

• Diabetic retinopathy- The patient in this case did not have diabetes.

• Hypertensive retinopathy- The patient in this case did not have hypertension.

• Central retinal vein occlusion- The fluorescein angiographic appearance shows no evidence of venous occlusion.

• Purtscher's retinopathy- Classically associated with chest trauma, this condition may also be seen in association with pregnancy, fat embolism and pancreatitis. None of these are relevant in this case.

• Leukemic retinopathy- Leukemias, in particular myeloid leukemia, may be associated with retinopathy. Features of leukemic retinopathy include preretinal and intraretinal haemorrhages. Other features include Roth’s spots, cotton wool spots, retinal venous tortuosity and neovascularization. There was no other evidence of leukemia in this case.

• Valsalva retinopathy- This will be discussed further in the Diagnosis and Discussion section.

• High-Altitude Retinopathy- This will be discussed further in the Diagnosis and Discussion section.
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