Optic disk pallor—Catch the masqueraders. Role of carotid angiography

Abstract

NA-AION is the most common ischemic optic neuropathy, with an incidence rate of 2.5–11.8 per 1,00,000 in the population older than 50 years. Patients at high risk of complications due to carotid atherosclerosis may only present with ophthalmic symptoms initially. We report here a case of a 52-year-old male with disk pallor, provisionally diagnosed as NAAION. On examination, his BP was raised, and had raised ESR and hypercholesterolemia on his blood work. CT Carotid angiogram revealed attenuated internal carotids on the side of involvement with a small eccentric hypodense plaque in the common carotid. This case report of frequently diagnosed NA-AION has been shared to lay emphasis on the importance of a thorough systemic workup in these patients, as their association with systemic illnesses like stroke and obstructive sleep apnea is well known. It will help in not only saving the other eye but also their lives from such life-altering diseases.