Atypical Anterior Optic Neuritis Resembles Anterior Ischemic Optic Neuropathy : A Unique Case Report

2017 ◽  
Vol 43 (2) ◽  
pp. 108
Author(s):  
Kristian Goenawan ◽  
Indra Tri Mahayana ◽  
Tatang Talka Gani ◽  
Hartono Hartono
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Optic Neuritis ◽  
Color Vision ◽  
Optic Neuropathy ◽  
Complete Blood Count ◽  
Anterior Segment ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Unique Case

Purpose : We present a unique case of atypical anterior optic neuritis resemble anterior ischemic optic neuropathy Methods : This was a single case study, with a patient was followed up for 2 months. Visual acuity, visual field, color vision, intraocular pressure, and ocular anatomy, were examined. Results : A female patient 54 y/o with chief complain sudden blurred vision on both eyes after woke up in the morning without redness and tearing 4 days before day of visit. History of systemic and ocular diseases were denied. Visual acuity was 0.5/60 (superior) right eye and 1/60 (superior) left eye, couldn’t be corrected. Relative afferent pupillary defect was observed in right eye. Biomicroscopic examination of anterior segment and intraocular pressures were normal. Funduscopy revealed ill defined margin at optic nerve head for both eyes suggested papilledema. At the present we couldn’t examined color vision. Visual field examination showed inferior altitudinal defect (more severe in right eye). Consultation to internal medicine and laboratory examination such as: complete blood count, lipid profile, blood glucose, and electrocardiogram were done to confirm our diagnosis. Clinically, the diagnosis of the disease more likely to be the anterior optic neuritis. Follow-up after 2 months has normal visual acuity, visual field, and color perception after steroid treatment. Conclusion : Anterior optic neuritis might have a very similar clinical presentation of anterior ischemic optic neuropathy upon early manifestation.

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 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.

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 AB0383 OCULAR MANIFESTATIONS DURING GIANT CELL ARTERITIS

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

Acquired Optic Nerve Diseases

Visual Fields ◽  
2010 ◽  
Author(s):  
Peter A. Quiros ◽  
Alfredo A. Sadun
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Neuritis ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Mass Effect ◽  
Ischemic Optic Neuropathy ◽  
Optic Nerve Diseases

This chapter focuses on the most frequently acquired optic nerve diseases: their signs and symptoms, visual field findings, and the required basic workup and management. Acquired optic nerve diseases are often vision threatening and sometimes even life threatening. There is a need for accurate and timely diagnosis. Therefore, it is incumbent on the clinician to identify optic neuropathies, separate them from chronic congenital and hereditary problems, and aggressively pursue the diagnosis and treatment as necessary. In the workup of optic neuropathies, the visual field is extremely helpful. All patients with suspected optic neuropathies require careful examination of the visual fields for detection, characterization, and monitoring. Acquired optic neuropathies include inflammatory, ischemic, compressive, metabolic, and central nervous system–reflected pathology (papilledema). Inflammatory optic neuropathies include optic neuritis and its various etiologies such as demyelination, infective, immune-mediated (atypical), and slowly progressive/ chronic. Ischemic optic neuropathies include nonarteritic ischemic optic neuropathy (NAION) and arteritic ischemic optic neuropathy (AAION). Metabolic optic neuropathies include nutritional and/or toxic etiologies. Compressive optic neuropathies can occur due to mass effect on the disc optic, gliomas, and perioptic meningiomas. Papilledema may be primary (pseudotumor cerebri) or secondary to central nervous system mass effect. Optic neuritis is defined as a primary inflammation of the optic nerve. It is characterized by central visual loss that worsens over days and usually peaks about 1 to 2 weeks after the onset. It is usually unilateral but may be bilateral, especially in children, following viral infections like measles, mumps, and chickenpox. It occurs most commonly in adults (18-45 years old). Orbital or periocular pain may be present or precede the visual loss and is exacerbated with eye movements. Etiologies include demyelinating diseases/multiple sclerosis;, idiopathic, viral, or bacterial infections (syphilis); contiguous inflammation of the meninges, orbit, or sinuses,; granulomatous inflammation (tuberculosis, sarcoidosis, and cryptococosis); and autoimmune diseases. It is the most common cause of acute visual loss from optic nerve disease in the young and middle-aged adult group.

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