DR. ADITHYA TELLAKULA

Dr. STEPHEN SUDHAKAR

Abstract

32 yr male presented with defective vision in LE since 6 months, which he noticed during routine ocular examination.

Visual Acuity in RE was 6/6 and LE was HM. Ocular examination revealed RAPD in LE. Fundus showed fine granular pigmentation in inferior retina and arteriolar narrowing in BE, with waxy disc pallor in LE. RE showed change in vascular calibre in inferior half of retina with corresponding superior altitudinal field defect. OCT revealed thinning of papillomacular bundle and FFA showed granular hypo fluorescence in BE. Vascular and neurological workup were normal with absent VEP response in LE.

Photopic ERG showed reduction BE, with LE>RE. Scotopic response was normal, suggestive of sporadic isolate cone dystrophy. This case is presented to highlight the overlapping retinal signs relating old CRAO and retinal photoreceptors dystrophies which delayed the diagnosis as there was no family history/consanguinity or classical symptoms. ERG is the key to diagnosis.