DR. NITYA TALAKOLA

DR. RAMAN YENUGANDULA

Abstract

A 44year old diabetic male presented with sudden onset,painless DOV in OS since 9months & OD since 1month

EXAMINATION:BCVA OD-CF1metre,OS-CF-CF ; Pupils-OU RAPD(OS>OD) ;Other anterior segment-normal ; Fundus-OD Partial Optic atrophy with sparing of nasal,few superior&inferior fibres;OS Total optic atrophy

INVESTIGATIONS:BP-140/80mmHg ;RBS-136mg/dl ;CBP-Neutrophilic Leukocytosis ;ESR-30mm/hour ;CMV IgG-positive ;RA factor-positive ;HIV1&HIV2-Non Reactive;VEP-Right:Prolonged P-100 latency ,Left:No reproducible potentials;Lipid profile-Hyperlipidemia;Serum Homocysteine- normal;CRP-normal;Mantoux test&IGRA-negative;ENMG study-normal;2DEcho-normal;Carotid Doppler-normal;MRI Brain&Orbits-normal;CSF Analysis-increased lymphocyte count;CSF Protein Electrophoresis-normal;VDRL-Non Reactive;NMO&MOG antibodies-negative

TREATMENT:Patient used Oral Valgancyclovir 450mgBD,Oral Steroids

RESULT:Patient’s vision improved in OD to 6/36