Dr. Saarang Hansraj

Dr. KARTHIKA NEMARUGOMMULA

Abstract

Male patient presented with sudden painless loss of vision 2w ago in the LE, BCVA is HM. BCVA in RE is 6/24. No history of blurring, floaters, flashes, pain, transient vision loss, redness, trauma, ocular surgery in affected eye. No h/o systemic complaints. He is a chronic smoker. Ant segment was normal. Fundus showed arteriolar attenuation, mild pallor in the macula, suspect cherry red spot in fovea. OD within normal limits. RE anterior, posterior segments were normal. Pt had BP of 140/102 mmHg. Due to severe vision loss, DD of CRAO and CSCR was made. OCT showed thickening of the inner retina, hyporeflection of the outer retina. FFA showed residual retinal circulation, increased arm-retina time, areas of delayed retinal perfusion. Diagnosis of NA-CRAO was made. Investigations showed a raised serum Homocysteine levels of 18umol/ml. Thus acute CRAO may mimic a relatively normal looking fundus and confuse residents. OCT and FFA are very helpful to diagnose and prognosticate such eyes