Bilateral simultaneous non-arteritic anterior ischemic optic neuropathy with occlusion of unilateral cilioretinal artery: A case report

Abstract

A 45-year-old female patient consulted our hospital for bilateral visual loss. She was receiving hemodialysis for 15 years. At presentation ophthalmologic examination, her visual acuity was hand movements in the right eye and light perception negative in the left eye. The direct light response was weak in the right eye and absent in the left eye. A total afferent pupillary defect was detected in the left eye. Fundoscopy revealed bilateral sectorial pale, sectorial hyperaemia and swollen optic discs. On the left papilla, there were splinter haemorrhages. At the right eye, there was pale edema at superior maculo-papillary bunch that coherent with occlusion of the cilioretinal artery. She was diagnosed as non-arteritic ischemic optic neuropathy based on the clinical and funduscopic examination. Methylprednisolone intravenous 1000mg/day for three days, then, oral methylprednisolone 1 mg/kg/day were administered for one week. Simultaneous acetylsalicylic acid 325 mg/day and hydration with 0.9% 1000cc isotonic solution treatment started. After two months, visual acuities did not change in both eyes, and both optic disks were pale.

Blinding Optic Neuropathy Associated With Carboplatin Therapy: A Case Report and Literature Review

“…In this case, several other illnesses that might potentially cause acute visual failure were considered. Nonarteritic ischemic optic neuropathy (NAION) is common in this age group and can cause abrupt visual loss and disc swelling, sometimes bilaterally [5][6][7]. However, our patient lacked systemic risk factors such as hypertension and hypercholesterolemia.…”

Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block

“…Only one other report [ 3 ] exists in the literature that describes unilateral ION that occurred after epidural block for emergency cesarean section, in which a hypotensive episode had occurred on administration of the anesthetic. Bilateral simultaneous AION has, however, been reported to occur spontaneously [ 5 ], after ingestion of sildenafil [ 6 , 7 ], with hypercoagulability [ 8 ] and vasculitis [ 9 ], with long-term hemodialysis [ 10 ], and after prostatic resection surgery under general anesthesia [ 11 ].…”