Subhyaloid hemorrhage as the first presenting sign of gastric adenocarcinoma

Abstract

A 43-year-old man presented to our clinic complaining of a sudden onset of reduced vision in both eyes. Full ophthalmological evaluation was performed. His visual acuity was finger counting at 1 meter in both eyes. The anterior segments were unremarkable. Fundus examination showed bilateral peripapillary and premacular subhyaloid hemorrhage, flame-shaped retinal hemorrhages and Roth’s spots (Fig. 1). A complete blood count was performed. The hematological evaluation was carried out. The patient’s platelet count was 35 × 109/L (normal range: 150—450 × 109/L); hemoglobin level was 8.8 g/dL (normal range: 13.3—17.2 g/L). Coagulation profile (prothrombin time and partial thromboplastin time) was normal. The patient was referred to a gastroenterologist. Endoscopy was performed after initial examination. He was diagnosed with gastric adenocarcinoma. Upper gastrointestinal system bleeding was controlled with medical treatment.