If the Treasure Room has already been entered and the item was not taken, then picking up More Options later on the same floor will not retroactively add a second item to the room.
The very rare Treasure Rooms that have either no item or two items that can both be picked up will be replaced with a one-out-of-two choice room, like other treasure rooms. In the latter case, this is a downgrade.
This page was last edited on 28 May 2020, at 18:00.
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