Abstract

A 20 YEARS OLD BOY PRESENTED WITH SUDDEN DIMINITION OF VISION IN RIGHT EYE ON WAKING UP IN THE MORNING. HIS VISUAL ACUITY WAS 6/60 PH 6/36 IN RIGHT EYE(NOT IMPROVING ON REFRACTION) AND 6/9 IN LEFT EYE. ANTERIOR SEGMENT EXAMINATION WAS NORMAL IN BOTH EYES. IOP WAS 17 AND 18. ON FUNDUS EXAMINATION RE MEDIA CLEAR DISC NORMAL EXTENSIVE HAEMORRHAGES PRESENT INFERIORLY, TEMPORAL AND NASAL QUADRANT. PERIVASCULAR SHEATING AND EXUDATES WERE PRESENT IN ALL 4 QUADRANTS. LE FUNDUS WAS NORMAL.OCT MACULA RE CSFT WAS 872MICRONS LARGE CYSTOID SPACES WERE PRESENT SUBFOVEALLY HRF PRESENT HYPERREFLECTIVITY IN INNER RETINAL LAYERS COORRESPONDING TO HEMORRHAGES PRESENT ILM FOLDS WERE PRESENT SUBFOVEALLY. LE CSFT 217 MICRONS REST WAS NORMAL.ALL INVESTIGATIONS(BLOOD AND RADIOLOGICAL)(ANTI CCP ,ANTI DS DNA, ANA, ACE, ANCA, HOMOCYSTEINE. X RAY CHEST, QUANTIFERON ) WERE NORMAL.THE PATIENT WAS STARTEDON ORAL PREDNISOLONE FROM 60MG TAPERING EVERY ONE WEEK FOR 6 WEEKS. HIS VISION IMPROVED TO 6/18.