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Bilateral non-arteritic ischemic optic neuropathy in a transsexual woman using excessive estrogen dosage
Katrien Wierckx1, Julie De Zaeytijd, Els Elaut
1Department of Endocrinology, Ghent University Hospital, 6K12 I.E., De Pintelaan 185, 9000, Ghent, Belgium, Katrien.Wierckx@ugent.be.
Abstract:
We present a case report on a 53-year-old transsexual woman who developed acute painless vision loss in both eyes during cross-sex hormone treatment. After 10 months of cross-sex hormone treatment, she experienced total vision loss of the right eye and, 6 months later, vision loss to 20/63 in the left eye. After a full ophthalmic exam, bilateral sequential non-arteritic ischemic optic neuropathy (NA-ION) was diagnosed. Extensive etiological work-up revealed no cardiac abnormalities or inherited blood-clotting disorders. A manifest self-administered overdose of transdermal estrogen treatment with serum estradiol levels of 5,765 pg/ml was possibly related to the sequential bilateral NA-ION resulting in nearly total vision loss in this transsexual woman.
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