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Acute visual loss in a patient with optic disc drusen

Authors Tan DK, Tow SL

Received 2 January 2013

Accepted for publication 15 February 2013

Published 30 April 2013 Volume 2013:7 Pages 795—799

DOI https://doi.org/10.2147/OPTH.S42233

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 1

Deborah KL Tan,1,2 Sharon LC Tow1–3

1Singapore National Eye Centre, 2Singapore Eye Research Institute, 3National University Health System, Singapore

Abstract: Here we report a case of sudden, unilateral, painless visual loss in a middle-aged patient. A 45-year-old gentleman with no known past medical history presented with acute painless left visual impairment. Clinically, he was found to have a left optic neuropathy associated with a swollen and hyperemic left optic disc. The right optic disc was noted to be small and crowded, and both optic discs were noted to have irregular margins. Humphrey perimetry revealed a constricted visual field in the left eye. Fundus autofluorescence imaging revealed autofluorescence, and B-scan ultrasonography showed hyperreflectivity within both nerve heads. Blood investigations for underlying ischemic and inflammatory markers revealed evidence of hyperlipidemia but were otherwise normal. A diagnosis of left nonarteritic anterior ischemic optic neuropathy (NAAION) was made, with associated optic disc drusen and hyperlipidemia. NAAION typically occurs in eyes with small, structurally crowded optic discs. The coexistence of optic disc drusen and vascular risk factors may further augment the risk of developing NAAION.

Keywords: optic disc drusen, ischemic optic neuropathy, painless visual loss

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