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Updated: May 21, 2026
06:49
The Rodent Model of Nonarteritic Anterior Ischemic Optic Neuropathy (rNAION)
Published on: November 20, 2016
An unusual cause for an optic disc haemorrhage
Julia Baxter1, Anusha Kailasanathan, Hean Chen
1Department of Ophthalmology, Royal Derby Hospital, Derby, Derbyshire, UK. julia.baxter@doctors.org.uk
BMJ Case Reports
|June 19, 2012
Summary
A myeloma patient on chemotherapy developed optic neuropathy and retinal necrosis due to cytomegalovirus infection. Prompt diagnosis and antiviral treatment are crucial for immunocompromised patients with visual disturbances.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Oncology
Background:
- Chemotherapy for multiple myeloma can compromise the immune system, increasing susceptibility to opportunistic infections.
- Optic neuropathy and retinal necrosis are severe ocular complications that can arise in immunocompromised individuals.
Observation:
- A 51-year-old male undergoing chemotherapy for myeloma presented with unilateral optic disc hemorrhage and optic neuropathy.
- The condition rapidly progressed to bilateral involvement, exhibiting retinal features of progressive outer retinal necrosis.
Findings:
- Serological tests confirmed cytomegalovirus (CMV) infection with positive immunoglobulin M antibodies.
- Despite treatment with intravenous acyclovir, later switched to ganciclovir, the patient experienced continued visual deterioration and retinal detachment.
Implications:
- This case highlights the critical need to consider and rapidly exclude infectious causes, such as CMV retinitis, in immunocompromised patients presenting with optic neuropathy and retinal necrosis.
- Early diagnosis and appropriate antiviral therapy are essential to prevent irreversible vision loss and ocular complications in this vulnerable patient population.
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