Dr.Minu Ramakrishnan
23 year old female presented with sudden DOV LE. Fundus examination showed multiple CWS and arterial attenuation with few haemorrhages in LE, with BCVA of 6/60. RE showed milder affection with BCVA of 6/18. FFA showed severe capillary nonperfusion and OCT showed NFL edema. She was adviced iv methylprednisolone , along with vasculitis workup. She was diagnosed as SLE, and started on Azathiaprine and systemic steroids. All along, she had a downhill course, with BE vision going down to FC 1 metre ( inspite of continued treatment) . Aspirin and Clopidegrol were added to her regimen with topical anti inflammatory eyedrops. At 1 month FU, she was stable with BCVA of FC 3 metres, repeat FFA showed better perfusion, and OCT showed atrophy of macula. At 3 months FU, her vision improved to 6/18 in the RE, and LE was stable at FC 3 metres. Patient regained satisfactory vision following the prolonged, severe and uncertain course of disease activity with prompt and appropriate management.
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