scholarly journals Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Rika Tsukii ◽  
Yuka Kasuya ◽  
Shinji Makino
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Visual Field Defect ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Swelling ◽  
The Right ◽  
Field Defect

To report a patient with nonarteritic anterior ischemic optic neuropathy (NA-AION) occurring soon after the COVID-19 vaccination. A 55-year-old woman presented with a 4-day history of inferior visual field disturbance in the right eye 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Examination revealed a best-corrected visual acuity of 20/20 in both eyes. A relative afferent pupillary defect was observed in the right eye. Fundoscopy revealed diffuse optic disc swelling in the right eye, which was prominent above the optic disc. Goldmann visual field testing identified an inferior altitudinal visual field defect with I/2 isopter in the right eye. Although typical complete inferior visual field defect was not detected, a diagnosis of NA-AION was made. The patient was followed without any treatment. During the 2-month follow-up period, the optic disc swelling was gradually improved, and visual acuity was maintained 20/20; however, the optic disc looked diffusely pale in the right eye. Although it is uncertain whether the development of NA-AION after COVID-19 vaccination was consequential or coincidental, we speculate that the close temporal relationship with COVID-19 vaccination suggests the possibility of vasculopathy on the microvascular network of optic nerve head as background of inflammatory or immune-mediated element to the timing of the onset of NA-AION. The aim of this case report is to present this biological plausibility and to elucidate potential ophthalmological complications.

scholarly journals Anterior ischemic optic neuropathy after transvenous coiling of dural arteriovenous fistulas: A case report

2019 ◽  
Author(s):  
Kazuyuki Majima ◽  
Kyoko Fujita ◽  
Shigeru Miyachi ◽  
Motohiro Kamei
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Coil Embolization ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Intraoperative Complication ◽  
Chorioretinal Atrophy ◽  
Nasal Defect ◽  
The Right

Abstract Background A dural arteriovenous fistula (dAVF) is defined as an abnormal arteriovenous direct connection in the dura mater, with the cavernous sinus (CS) being one of the most common locations. Transarterial or transvenous embolization remains the first-line treatment for most dAVF, although these procedures are associated with rare sight-threatening ophthalmic complications. We report a case of nonarteritic anterior ischemic optic neuropathy (nAION) following successful treatment of dAVF with a coil embolization. Case presentation A 76-year-old woman complained of conjunctival hyperemia in both eyes 1 month prior to visiting our hospital. She was diagnosed with bilateral dAVF based on magnetic resonance angiography (MRA). On ophthalmic examination, her best-corrected visual acuity (BCVA) was 0.8 in the right eye and 0.7 in the left. Intraocular pressure was 27 mmHg in the right and 24 mmHg in the left. Extraocular movements were limited in all directions. Slit lamp examination disclosed red eyes with dilated corkscrew vessels. Funduscopic examination revealed normal findings in both eyes except a partial chorioretinal atrophy in the left eye. Goldmann perimetry revealed an inferior nasal defect corresponding to the chorioretinal atrophy in the left eye and normal visual field in the right eye. Transvenous coil embolization of the right CS was performed. The dAVF was completely embolized and there was no intraoperative complication. Follow-up brain MRA showed no evidence of residual dural fistula. Ten days after embolization, she developed double vision and visual disturbance in the right eye. Her right BCVA was 0.8. Fundus examination revealed pallor papilledema and splinter hemorrhages at the optic disc edge in her right eye. Fluorescein angiography showed hypofluorescence around the optic disc and a nasal lesion in the early phase. Goldman perimetry revealed lower altitudinal hemianopsia in the right eye. From these findings, nAION was diagnosed. During hospitalization, her right BCVA decreased to 0.08. Ten months later, funduscopy revealed right temporal optic disc pallor without edema, and her right visual acuity remained at 0.08. Conclusions We report a case of nAION after embolization of dAVF located in CS. This complication should be considered after embolization for dAVF.

scholarly journals The anterior ischemic optic neuropathy treatment using the dispersed “Alloplant”

2013 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Venera Uzbekovna Galimova ◽  
Irina Viktorovna Verzakova ◽  
Yevgeniy Musinovich Gareyev ◽  
Zarina Khikhmetullovna Karimova
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Blood Supply ◽  
Optic Neuropathy ◽  
Visual Fields ◽  
Resistance Index ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Ciliary Arteries ◽  
Lateral Branches

In this article, the results of a study are presented on the influence of the therapeutic retroscleral filling by dispersed “Alloplant” biomaterial upon blood supply and visual functions of the eye. 47 patients (69 eyes) suffering from anterior ischemic optic neuropathy sequelae were examined. Obtained results allowed to study the degree of relationship between the following indices: resistance index of ocular vessels, visual acuity and electrophysiological data, visual field limits. The majority of cases with significant visual fields widening (79 %) correlated with post-operative decrease of resistance index in posterior short ciliary arteries (medial and lateral branches). The results of performed investigation allow to assume that the dispersed “Alloplant” biomaterial use in the treatment of patients with anterior ischemic optic neuropathy sequelae could promote the optic nerve blood supply improvement with further amelioration of visual function indices.

Clinical and Etiological Profile of Patients with Optic Disc Edema in Tertiary Care Centre of Nepal

2019 ◽  
Vol 41 (1) ◽  
pp. 24-30
Author(s):  
Ritish K Shah
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Optic Neuritis ◽  
Color Vision ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Tertiary Care ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Edema ◽  
Disc Edema

Introduction: Optic disc edema can be a manifestation of various neurological disorders. Identification of those causes is possible in most cases using tests like visual acuity, color vision, visual field and suitable radiological imaging. Study in Nepalese population with regard to optic disc edema is scarce. Hence this study aims to act as a guideline for evaluation of such cases and help in further studies in this regard. Methods: A descriptive, cross-sectional study was conducted in all cases of optic disc edema presenting to neuro-ophthalmology clinic of B.P. Koirala Lions Centre for Ophthalmic Studies from January 2011 to June 2012. A detailed history was obtained and proper ocular and nervous examination was done by ophthalmologist and neuro-physician. Assessment of visual acuity, color vision, contrast sensitivity and visual field along with radiological tests were done in all possible cases. Results: Out of all the cases evaluated, 38 cases where causes of optic disc edema could be established were included in the study. The commonly affected age group was 31 to 40 years (26.3%) and most of them were males. The commonest cause observed was optic neuritis (36.8%). Others were papilledema, idiopathic intracranial hypertension, toxic optic neuropathy, non-arteritic anterior ischemic optic neuropathy (NA-AION), compressive and traumatic optic neuropathy. Conclusion: Optic neuritis and papilledema should be considered as common differential diagnosis in patients with optic disc edema. NA-AION is a relatively uncommon disease among Nepalese population.

scholarly journals Optic Nerve Head Microcirculation in Eyes with Vogt-Koyanagi-Harada Disease Accompanied by Anterior Ischemic Optic Neuropathy

2021 ◽  
pp. 899-908
Author(s):  
Yui Yamashita ◽  
Yuki Hashimoto ◽  
Kenichi Namba ◽  
Kazuomi Mizuuchi ◽  
Susumu Ishida
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Optic Disc Swelling ◽  
Vkh Disease ◽  
Field Defects

Anterior ischemic optic neuropathy (AION) is infrequently complicated with Vogt-Koyanagi-Harada (VKH) disease. We quantitatively examined sequential changes in the morphology and circulation hemodynamics, using a C-scan of optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION. A 65-year-old female complained of blurred vision in both of her eyes. The patient presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. The diagnosis of VKH disease was established based on the presence of pleocytosis detected in the cerebrospinal fluid and hypofluorescent dark dots scattered all around the fundus, detected by indocyanine green angiography. Goldmann perimetry detected visual field defects, similar to superior altitudinal hemianopsia in the right eye and similar to inferior altitudinal hemianopsia in the left eye. The patient was suspected to have developed AION in both eyes. The patient received methylprednisolone pulse therapy, followed by oral prednisolone. With these treatments, the optic disc swelling disappeared. However, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed the decrease in optic nerve head (ONH) tissue microcirculation. These results supported the occurrence of AION in this patient with VKH disease. The analysis of GCC and cpRNFL thickness and ONH microcirculation would be useful for supporting the occurrence of AION in a case of VKH disease.

scholarly journals Presumed clomiphene-induced optic neuropathy: A case report

2021 ◽  
Author(s):  
Yousef Alizadeh ◽  
Zahra Moravvej ◽  
Yaser Khakpour ◽  
Ebrahim Azaripour ◽  
Mitra Akbari ◽  
...  
Keyword(s):  
At Risk ◽  
Visual Acuity ◽  
Optic Neuropathy ◽  
Clomiphene Citrate ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Acute Visual Loss ◽  
Estrogen Receptor Ligand ◽  
Sudden Decrease ◽  
The Right

Background: Clomiphene citrate is an estrogen receptor ligand with mixed agonistic–antagonistic properties used for the treatment of female and male infertility. Various visual disturbances and several irreversible visual outcomes have been associated with clomiphene citrate. In this report, we present a patient with presumed clomiphene-induced optic neuropathy. Case: A 33-yr-old man with acute visual loss of the right eye was referred to Amiralmomenin Hospital, Rasht, Iran in November 2018. His only medication was clomiphene citrate 100 mg daily, taken for 2 wk for fertility issues. The patient presented with a sudden decrease of visual acuity in the right eye on the 14th day of starting the treatment and subsequently developed complete loss of inferior visual field within a few days. On examination, the visual acuity was 6/20 in the right and 20/20 in the left eyes, with a right relative afferent pupillary defect and decreased red color saturation. The fundus examination revealed optic disc swelling with venous dilation in the right eye and a normal left fundus with a crowded disc (disc-at-risk). The patient was evaluated for systemic disorders, all of which were normal. Findings were suggestive of non-arteritic anterior ischemic optic neuropathy most likely due to clomiphene. Conclusion: As clomiphene may increase blood viscosity, it is hypothesized that reduced flow in a posterior ciliary artery in conjunction with the disc-at-risk contributes to the anterior ischemic optic neuropathy. It is advised that patients with disc-at-risk be aware of the possible non-arteritic anterior ischemic optic neuropathy and those experiencing visual symptoms while taking clomiphene be examined promptly for evidence of optic nerve injury. Key words: Clomiphene citrate, Optic neuropathy, Visual acuity, Ischemia.

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