Dr. M Manjunath, M09865
A 60 yrs old female patient presented with chief complaint of defective vision in both eye for 2 months duration. No H/O trauma, pain, redness and systemic illness.O/E Her BCVA in RE- 6/60 and LE -6/18. NCT (BE) -10mm of Hg.Anterior segment was normal both eyes. Fundus examination shows dilated and tortuous vessels with Macular edema.
We advised routine blood investigation, FFA and OCT. Blood investigation shows Hb – 7.2gm%.TC- 6900 DC- N-54,L-33,E-13,M-0,-B-0. ESR- 160mm/hr, RBCsdecreased, platelets- just adequate.PBS – Marked Normochromic Normocytic Anemia with extensive rouleaux formation.FFa – Shows dilated and tortuous vessels, FAZ within normal limits and no e/o CME.OCT – shows gross macular edema with foveal detachment at macula. RE CMT-1091microns , LE CMT -437microns .
Clinically diagnosed as a case of SILENT MACULA because of hyper viscosity syndrome.Further investigation done to rule out HVS …( Lympho proliferative disorders, multiple myeloma and waldenstrom macroglobulinemia).
Skull, spinal, chest and sac