Bilateral Macular Hemorrhage Revealing Severe Thrombocytopenia in an AIDS Context about a Case Report

We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly during HIV infection. Its frequency increases with the decrease in CD4 T lymphocytes and the passage to the AIDS stage. Its pathophysiology in this context is complex and multifactorial. Hemorrhagic complications usually appear for platelets less than 50,000/mm3 and this risk is greater at a rate of less than 20,000/mm3. Retinal hemorrhages may go unnoticed, only macular localization results in clinical expression. OCT is of paramount importance in accurate topographic diagnosis of macular hemorrhages by locating their seats which can be pre, intra or under retinal. Management requires the balance of infectious and hematologic factors. Ophthalmic surgical treatments should be considered in a second step.