Papillomacular Bundle and Inner Retinal Thicknesses Correlate With Visual Acuity in Nonarteritic Anterior Ischemic Optic Neuropathy

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.

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Bilateral Non-Arteritic Anterior Ischemic Optic Neuropathy in a Patient with Autoimmune Thrombocytopenia

European Journal of Ophthalmology ◽

10.1177/112067210001000216 ◽

2000 ◽

Vol 10 (2) ◽

pp. 180-182 ◽

Cited By ~ 6

Author(s):

H.E. Killer ◽

A. Huber ◽

C. Portman ◽

A. Forrer ◽

J. Flammer

Keyword(s):

Visual Acuity ◽

Platelet Count ◽

Case Report ◽

Optic Neuropathy ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Good Recovery ◽

Autoimmune Thrombocytopenia ◽

Low Platelet Count

Purpose To describe a patient with bilateral non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic autoimmune thrombocytopenia (ITP) with an extremely low platelet count. Method Case report. Results Remarkably good recovery of visual acuity. Conclusions Bilateral non-arteritic anterior ischemic optic neuropathy can develop in the presence of a very low platelet count.

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

Case Reports in Ophthalmological Medicine ◽

10.1155/2021/5126254 ◽

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.

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

10.21203/rs.2.389/v1 ◽

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.

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Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

Case Reports in Medicine ◽

10.1155/2012/747658 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 12

Author(s):

Anna Tarantini ◽

Alessandra Faraoni ◽

Francesca Menchini ◽

Paolo Lanzetta

Keyword(s):

Visual Acuity ◽

Erectile Dysfunction ◽

Case Report ◽

Optic Neuropathy ◽

Oral Prednisone ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Pde Inhibitors ◽

Sudden Decrease ◽

Predisposing Conditions

Purpose. To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction.Methods. Observational case report.Results. A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion. A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intravenously, followed by oral prednisone 75 mg/d. Final visual acuity was 20/50 right eye (OD) and 20/20 left eye (OS). He had preexisting diabetes.Conclusion. This is the first reported case of simultaneous bilateral NAION occurred in a diabetic patient early after Sildenafil intake. Patients with predisposing conditions such as diabetes have to be warned against the use of PDE inhibitors.

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Irreversible Anterior Ischemic Optic Neuropathy Complicating Interferon Alpha and Ribaverin Therapy

International Journal of Hepatology ◽

10.4061/2011/814242 ◽

2011 ◽

Vol 2011 ◽

pp. 1-2 ◽

Cited By ~ 3

Author(s):

Hassan Seddik ◽

Mouna Tamzaourte ◽

Fadoua Rouibaa ◽

Maha Fadlouallah ◽

Ahmed Benkirane

Keyword(s):

Visual Acuity ◽

Chronic Hepatitis ◽

Optic Neuropathy ◽

Interferon Therapy ◽

Antiviral Treatment ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Interferon Treatment ◽

Ocular Complications ◽

Uncommon Complication

Ophthalmologic complications with interferon therapy are rare and usually reversible. The anterior ischemic optic neuropathy is an uncommon complication of interferon treatment. A case of irreversible anterior ischemic optic neuropathy complicating interferon therapy for chronic hepatitis C is reported. We suggest that periodic ophthalmological examinations, including visual acuity and fundus examinations, should be performed to patients with high risk of ocular complications after starting and during treatment. We also suggest that an ophthalmologist would be able to detect these complications. Antiviral treatment should be stopped immediately if severe ophthalmologic complications occur.

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AB0383 OCULAR MANIFESTATIONS DURING GIANT CELL ARTERITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4143 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1219.1-1219

Author(s):

A. Mzabi ◽

N. Adaily ◽

L. Ines ◽

I. Ben Hassine ◽

J. Anoun ◽

...

Keyword(s):

Internal Medicine ◽

Visual Acuity ◽

Optic Neuritis ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Optic Neuropathy ◽

Medecine Interne ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Horton’S Disease

Background:Horton’s disease (HD) or giant cell arteritis (GCA) is a segmental and plurifocal giant cell inflammatory panarteritis, predominant in large and medium sized vessels. Ocular damage during giant cell arteritis is frequent and is considered the most serious damage, possibly causing blindness in 15% of cases in recent series (1).Objectives:Describe the different ophthalmological manifestations during GCA.Methods:This is a retrospective monocentric descriptive study of 19 files of subjects diagnosed with HD, hospitalized in the internal medicine department of de Sousse between January 2000 and December 2020.Results:The average age of patients at diagnosis was 70 years, with extremes of 53 and 92 years. There were 14 females (71.4%) and 5 males (28.6%). Ophthalmologic manifestations were present in 13 patients (71%), 6 of whom were female.Decreased visual acuity was reported in 8 cases (58.33%) with biolateral blindness in one case, visual blur in 9 cases (75%), eye pain in two cases.Ophthalmological examination was normal in 8 cases (42%). A decrease in visual acuity was objective in 4 cases (21%). One case of nodular episcleritis was noted. The fundus showed anterior ischemic optic neuropathy in 2 cases (10.5%) and left optic atrophy in another case. A visual field was performed in 2 cases showing associated retrobulbar optic neuritis. Therapeutically, Methylprednisolone boli were prescribed in patients with anterior ischemic optic neuropathy, followed by oral corticosteroid therapy at a dose of 1mg/kg/day. A dose of 0.7 mg/kg/day of prednisone was prescribed in the other cases. Blindness was irreversible.Conclusion:The most common eye diseases in HD are acute anterior ischemic optic neuritis, retinal artery occlusion and posterior ischemic optic neuropathy. Episcleritis is a rare ophthalmologic manifestation of this vasculitis (2). More exceptionally, Horton’s disease may cause NORB by affecting the vessels that supply the optic nerve (< 5% of cases)(3,4). In our series of studies, acute anterior ischemic optic neuritis was less observed than in the literature. This is probably due to the reduced number of patients.References:[1]M.Khedher. I.Rachdi. Z.Aydi. F.Daoud. B.Ben Dhaou. F.Boussema. Eye damage during Horton’s disease: about 42 cases. La Revue de Médecine Interne 2017; 38:115.[2]Rim Klii. Wafa Chebbi. Nodular episcleritis: an unusual inaugural manifestation of Horton’s disease. Pan Afr Med J 2015; 21: 20.[3]M.EssouriI.RachdiF.DaoudZ.AydiH.ZoubeidiB.Ben Dhaou et al. Retrobulbar Optic Neuropathy in Internal Medicine. La Revue de Médecine Interne 2018; 39: 132.[4]M A González-Gay, C García-Porrúa, J Llorca, A H Hajeer, F Brañas, A Dababneh et al. Visual manifestations of giant cell arteritis. Trends and clinical spectrum in 161 patients. Medicine (Baltimore) 2000;79(5):283-92.Disclosure of Interests:None declared

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Presumed clomiphene-induced optic neuropathy: A case report

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v19i5.9257 ◽

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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Use of Intravitreal Dexamethasone in a Case of Anterior Ischemic Optic Neuropathy

Case Reports in Ophthalmology ◽

10.1159/000479785 ◽

2017 ◽

Vol 8 (2) ◽

pp. 452-458 ◽

Cited By ~ 4

Author(s):

Raffaele Nuzzi ◽

Francesca Monteu

Keyword(s):

Visual Acuity ◽

Optic Neuropathy ◽

Visual Fields ◽

Significant Loss ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

High Concentration ◽

Acute Therapy ◽

Systemic Corticosteroids ◽

Intravitreal Dexamethasone

Nowadays there is no unique and well-established treatment for nonarteritic anterior ischemic optic neuropathy, despite being the main acute pathology that affects the optic nerve in the elderly population and often resulting in a significant loss of visual acuity. The effectiveness of oral steroids is still under debate in the international literature, although many studies show that patients treated with high doses of systemic corticosteroids have a significantly higher chance of improved visual acuity and visual fields. The authors propose an intravitreal dexamethasone injection/implant as initial and acute therapy. Compared to systemic corticosteroids, intravitreal dexamethasone has the advantage of avoiding any systemic side effects of steroids. On the other hand, a rise in intraocular pressure might occur, manageable with local antiglaucoma drugs, especially in patients at risk, and there is a risk of induced cataract. The pharmacodynamics of the intravitreal dexamethasone slow-release implant is characterized by a first step with high release concentrations and a second following phase with decreasing concentrations. Therefore, the use of emergency dexamethasone (high concentration) intravitreal injection is justified as a treatment after the first detection of an ischemic optic anterior neuropathy.

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Clinical Efficacy Observation of Acupuncture Treatment for Nonarteritic Anterior Ischemic Optic Neuropathy

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/713218 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Yali Qin ◽

Wei Yuan ◽

Hui Deng ◽

Zhanmei Xiang ◽

Chao Yang ◽

...

Keyword(s):

Visual Acuity ◽

Clinical Efficacy ◽

Optic Neuropathy ◽

Acupuncture Treatment ◽

Alternative Therapy ◽

Light Sensitivity ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Complementary And Alternative Therapy ◽

Significant Difference

Objective. To determine whether acupuncture treatment impacts the clinical efficacy of degenerative damage of the optic nerve caused by nonarteritic anterior ischemic optic neuropathy (NAION).Methods. 69 patients (93 eyes) with NAION who had been treated by acupuncture which is performed on different acupoints related to eyes by vertical insertion or Fingernail-pressure needle insertion. The best corrected visual acuity, mean defect (MD) and mean light sensitivity (MS) of the visual field, and latency and amplitude of pattern visual evoked potential (P-VEP) were compared before and after treatment.Results. After 2, 4, and 8 weeks of treatment, the total effective rates of visual acuity improvement were 74.19%, 78.89%, and 81.71%, respectively, and the decreased MD and increased MS were both statistically significant (P< 0.01). When compared with the situation before treatment, the average latency of the P100wave was significantly reduced (P< 0.05), and the average amplitude was improved with no statistically significant difference (P> 0.05).Conclusions. Acupuncture treatment could obviously improve the visual function of patients with NAION and be used as complementary and alternative therapy in clinic.

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