End-stage renal disease (ESRD) is associated with a number of serious complications, including increased cardiovascular disease, anaemia and metabolic bone disease. Optic atrophy secondary to chronic anaemia in ESRD is rare. We report a case of bilateral optic atrophy in a young patient with chronic anaemia secondary to ESRD. A 23-year-old lady with ESRD, presented with progressive blurring of vision in her left eye for a period of six months. Visual acuity in the left eye was counting finger and the right eye was 6/6. Left optic nerve functions were significantly reduced. Bilateral anterior segments and intraocular pressure were normal. Funduscopy showed bilateral pale disc with arteriolar attenuation. The infective, autoimmune and demyelinating screening were negative. Serial full blood count indicated low haemoglobin and haematocrit value. The full blood picture revealed normocytic normochromic anaemia. Neuroimaging was normal. The patient was diagnosed as having bilateral optic atrophy secondary to chronic anaemia due to ESRD. Chronic anaemia is a potential cause of optic atrophy in a young patient with chronic disease. Management of anaemia in such cases is crucial to prevent irreversible complications including optic atrophy and blindness.

Background: Levetiracetam is broad spectrum, second generation antiepileptic drug which is highly tolerated in children with minor adverse events. Studies evaluating the effect of levetiracetam on hematological parameters have reported an unexplained increased incidence of infections such as pharyngitis and rhinitis. There have been case reports of pancytopenia, thrombocytopenia, eosinophilia and lymphopenia. However, cases of isolated low red blood cell counts, hemoglobin and hematocrit as compared to placebo are reported. Aim of Study: This study aimed to evaluate the changes in complete blood picture, prothrombin time, partial thromboplastin time and platelet functions in children with idiopathic epilepsy who were treated with levetiracetam as monotherapy. Patients and Methods: This study was conducted on fifty children of both sexes presented with idiopathic epilepsy during the period from June 2016 to May 2017. Patients were assessed by monitoring complete blood picture, prothrombin time, partial thromboplastin time and platelet functions before and 6 months after receiving levetiracetam monotherapy. Results: There were no significant alterations in the evaluated parameters during the study after levetiracetam administration when compared to results before treatment. Conclusion: Levetiracetam monotherapy has proven to be well tolerated in treatment of children with idiopathic epilepsy and does not appear to cause significant changes in complete blood picture, prothrombin time, partial thromboplastin time and platelet functions.