Related Experiment Videos
Optic disc structure and shock-induced anterior ischemic optic neuropathy
Rod Foroozan1, Lawrence M Buono, Peter J Savino
1Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson University, 900 Walnut Street, Philadelphia, PA 19107, USA.
Ophthalmology
|February 13, 2003
Summary
An 80-year-old man experienced vision loss due to shock-induced anterior ischemic optic neuropathy (SIAION) after gastrointestinal bleeding. He later developed nonarteritic anterior ischemic optic neuropathy (NAION) in the other eye, suggesting anemia and optic disc shape contributed to both events.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Anterior ischemic optic neuropathies (AION) are common causes of sudden vision loss.
- Nonarteritic anterior ischemic optic neuropathy (NAION) and shock-induced anterior ischemic optic neuropathy (SIAION) are distinct but related conditions.
Observation:
- An 80-year-old male presented with unilateral vision loss in the right eye following severe anemia from gastrointestinal hemorrhage.
- Neuro-ophthalmic examination revealed findings consistent with SIAION in the right eye.
- Eight weeks later, the patient developed vision loss in the left eye, diagnosed as NAION, despite improving hemoglobin levels.
Findings:
- The patient experienced sequential ischemic optic neuropathies: SIAION in the right eye secondary to acute anemia, followed by NAION in the left eye.
- The timing suggests acute anemia precipitated the initial event, while optic disc morphology may have predisposed to both episodes.
- Laboratory results showed initial severe anemia (hemoglobin 6.7 g/dl) and later improvement (11.9 g/dl) with normal inflammatory markers.
Implications:
- This case highlights the potential role of severe anemia and shock in precipitating SIAION.
- Optic disc configuration may be a significant risk factor for both SIAION and NAION.
- Understanding these associations can aid in the diagnosis and management of ischemic optic neuropathies.