DR. SARANYA THIRUNTHAIYAN

DR.KALAISELVI BALASUBRAMANIAN, DR.LATHA K.S.T., DR. SHEELA SUBRAMAMAN

Abstract

A 23 year old male,a case of TOF on conservative management presented with c/o defective vision RE for 3 days.He had BCVA 6/9 RE and 6/6 LE. Anterior segment examination revealed RAPD in RE.RE showed peripheral visual field defect .His intraocular pressure and color vision were within normal limits.RE fundus examination showed disc margins blurring,venous tortuosity,arteriolar attenuation,cloudy swelling of posterior pole sparing papillomacular area S/O RE CRAO with cilioretinal artery sparing.His HB was 16.5g with normal platelet and WBC count.peripheral smear showed elevated normocytic normochromic RBCs S/O polycythemia secondary to hypoxemia in cyanotic heart disease.His homocysteine level was elevated(24mcmol/L)due to hypoxia altering the remethylation of homocysteine in hepatocytes.CV Doppler showed no occlusion.He was referred to hematology clinic and started on antiplatelets,anticoagulants,folate and vitB12.This case is presented for rarity with incidence 8.5 cases per 10000.