Dr. arpita acharya

Abstract

A 39-year man complained of sudden decreased in vision in right eye which started 1 day before. His medical and ophthalmic histories were unremarkable. Initial examination showed visual acuity of 20/30 in OD and 20/20 in OS. Findings of anterior segment slit lamp biomicroscopy were unremarkable in both eyes. IOP was 16mmHg in both eyes. Fundus finding in right eye revealed retinal whitening just temporal to disc in wedge pattern, dilated veins

and scattered haemorrhages. The left eye fundus was normal. OCT done through white lesion showed intermittent and discreet areas of increased hyperreflectivity in the inner nuclear layer in perifoveal region. Serum homocysteine was found raised. Tablet homocheck was given. Reviewed after 1-month, ophthalmologic examination showed partial resolution and vision improved to 20/25. PIRW is a transient useful fundus sign of CRVO that can precede other signs. Familiarity with this sign, will help accurate diagnosis and counselling.