DR. JAI MERCY JAMES

DR. C. ARAVIND BABU

Abstract

30year old male chronic alcoholic with painless bilateral diminution of vision for 10 days with no other comorbidities on examination was found to have severe pallor,bilateral pedal edema and hepatosplenomegaly.Visual acuity in both eyes was 6/36 with pinhole no improvement and bilateral fundus showed tortuous vessels, superficial and deep hemorrhages along the vascular arcades and macula.Blood investigations showed hemoglobin of 4gm,WBC of 2300/cumm,platelet of 4500cells/cumm, MCV 115.6cumm,MCH 41.5pg,MCHC 35.9%,Serum vitB12 49pg/ml and folic acid 3.50ng/ml.Peripheral smear showed pancytopenia, UGI scopy with biopsy done showed chronic gastritis with superficial mucosal hemorrhages with lymphoid aggregate formation.Patient received 2 units of blood transfusion,Vitamin B12 and folic acid following which Hemoglobin improved to 7.8gm/dl and platelet 1lakh/cumm.2 weeks after treatment visual acuity improved to 6/9 bilaterally and resolution of sub retinal and macular hemorrhages.