Abstract

A 39 year old male brought to EMD with sudden onset of chest pain with BP -240/160mmHg,diagnosed as Acute Inferior Wall Myocardial Infarction.Prompt thrombolysis using reteplase was done. During thrombolysis patient noticed sudden painless loss of vision .O/E visual acuity was Hand movements in the LE.Anterior segment was normal. Posterior segment examination revealed preretinal,intraretinal haemorrhage and vitreous haemorrhage. RE shows moderate hypertensive retinopathychanges.The patient was kept on head end elevation and constant observation.Coronary artery angiography was deferred in view of worsening haemorrhage. After 1 week VA improved to 6/60 and intraocular haemorrhage was decreasing.Posterior pole was visible revealing dark reddish placque like lesion measuring 1 disc diameter over superotemporal arcade with surrounding circinate exudates. From the above findings we concluded that intraocular hemorrhage was likely to be from ruptured retinal artery macroaneurysm.