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Case Studies | Ophthalmology | India | Volume 12 Issue 5, May 2023 | Popularity: 4.9 / 10

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Can Save Vision in Haemorrhagic Crisis: A Case of Evans Syndrome, Presenting as Vitreous Haemorrhage

Dr. Ruchika Jain, Dr. Satish Desai

Abstract: Evans syndrome is a rare condition characterized by simultaneous or sequential development of autoimmune hemolytic anemia and immune thrombocytopenia (and/or immune neutropenia) A 30 year old lady present with diminision of vision of both eyes to light perseption and perseption of rays. It was associated with pervaginal bleeding, red colour urine, recurrent apathus ulcer and abdominal pain. On investigation presence of antierythrocyte antibodies detected by direct antiglobulin test in combination with haemolytic anemia with severe thrombocytopenia in presence of normal leucocyte count was present with detection of AIHA along with ITP confirming the diagnosis of Evan syndrome. On distant direct fundoscopy dull glow was present. On indirect ophthalmoscopy dense vitreous hemorrhagic seen covering the retina. After multiple transfusion and iv immunoglobulins visual acuity improves to CF 1/2 m. Further B/L vitrectomy done lead to improvement of visual acuity to 6/60. Detailed ophthalmological evaluation is of paramount importance in any bleeding disorder. Prompt treatment can lead to early visual rehabilitation.

Keywords: Evans syndrome, Autoimmune haemolytic anemia, vitreous haemorrhage, Pars plana vitrectomy

Edition: Volume 12 Issue 5, May 2023

Pages: 96 - 98

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