J Korean Ophthalmol Soc.  2013 Dec;54(12):1960-1965.

A Case of Acute Nonarteritic Anterior Ischemic Optic Neuropathy in Patient on Hemodialysis

• Kwak AY
• Kim GA
• Choi JB

Abstract

PURPOSE
To report a case of non-arteritic anterior ischemic optic neuropathy (NAION) in a patient on hemodialysis.
CASE SUMMARY
A 59-year-old female undergoing intravenous hemodialysis developed sudden blurred vision for 2 days. Chronic hypotension and anemia may have been persisted for approximately 6 months before the onset of symptoms. Her corrected visual acuity in both eyes was 0.7 and visual field test showed superior arcuate defect in the left eye. Fundus photography showed inferonasal optic disc swelling and fluorescein angiography revealed hyperfluorescence of the disc in the late phase which was probably attributable to NAION. After 3 weeks, corrected visual acuity was 0.7 in the left eye and fundoscopic finding of the left eye was improved.
CONCLUSIONS
Hemodialysis can cause a hypotensive event and anemia which may be associated with NAION. Avoiding acute hypotension and anemia should be advised to prevent development of NAION in dialysis patients.

Keyword

Anemia; Hemodialysis; Hypotension; Non-arteritic anterior ischemic optic neuropathy

MeSH Terms

Anemia
Dialysis
Female
Fluorescein Angiography
Humans
Hypotension
Middle Aged
Optic Neuropathy, Ischemic*
Photography
Renal Dialysis*
Visual Acuity
Visual Field Tests

Figure

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  Figure 1. Humphrey visual field test shows arcuate defect at superior field of the left eye.

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  Figure 2. (Left) At the first visit, fundus photograph revealed optic disc swelling of the inferonasal optic nerve head in the left eye. (Right) Fundus photograph shows decreased optic disc swelling in the left eye after 3 weeks.

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  Figure 3. Fundus fluorescein angiography shows hyperfluorescence of the optic disc at the late phase.

Reference

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