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Acute visual loss in a patient with optic disc drusen
Deborah Kl Tan1, Sharon Lc Tow
1Singapore National Eye Centre, Singapore ; Singapore Eye Research Institute, Singapore.
Clinical Ophthalmology (Auckland, N.Z.)
|May 10, 2013
Summary
Sudden vision loss in one eye can signal nonarteritic anterior ischemic optic neuropathy (NAAION). Optic disc drusen and hyperlipidemia may increase the risk of this serious condition.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Nonarteritic anterior ischemic optic neuropathy (NAAION) is a common cause of sudden, painless vision loss.
- It typically affects middle-aged individuals and is associated with vascular risk factors and crowded optic discs.
Observation:
- A 45-year-old male presented with acute, unilateral, painless visual impairment.
- Clinical examination revealed left optic neuropathy with a swollen, hyperemic optic disc.
- The contralateral optic disc was small and crowded, with irregular margins in both eyes.
Findings:
- Humphrey perimetry showed a constricted visual field in the affected left eye.
- Fundus autofluorescence and B-scan ultrasonography indicated hyperreflectivity in both optic nerve heads.
- Blood tests confirmed hyperlipidemia but were otherwise unremarkable.
Implications:
- The patient was diagnosed with left NAAION, optic disc drusen, and hyperlipidemia.
- This case highlights that optic disc drusen and vascular risk factors may increase susceptibility to NAAION.
- Early recognition and management of vascular risk factors are crucial in preventing further visual impairment.
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