DR. JAY OSWAL

DR. VIRNA SHAH, DR. KARTHIK KUMAR MANI

Abstract

A 30-year-old female presented with sudden loss of vision & pain in left eye(LE), associated with headache. On examination, BCVA was FCF with RAPD grade III in LE disc edema with haemorrhages having a white centre in the inferonasal quadrant, suggestive of Roth spots.RE VA was 6/6, ant.& post.segments were normal.Patient underwent blood investigations,MRI(brain + orbit),Optical Coherence Tomography (OCT),Fundus Fluorescein Angiography (FFA).MRI confirmed the diagnosis of LE optic neuritis(ON),with long segment involvement. Patient was treated with IV Methyl Prednisolone 1 gm OD for 3 days followed by oral steroids 1mg/kg BW for 11 days(as per ONTT). On follow up, her BCVA LE was 6/6 with resolved disc edema. Anti-MOG antibody & Anti – Aquaporin 4(NMO-IGG)antibody were negative. So far only 1 case has been reported in literature, but that was MOG +ve optic neuritis with Roth spots.We present a unique case of a middle-aged female who presented with double seronegative ON with Roth spots.