Tan Deborah Kl, Tow Sharon Lc
Singapore National Eye Centre, Singapore ; Singapore Eye Research Institute, Singapore.
Clin Ophthalmol. 2013;7:795-9. doi: 10.2147/OPTH.S42233. Epub 2013 Apr 30.
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.
在此，我们报告一例中年患者突发单侧无痛性视力丧失的病例。一名45岁男性，无已知既往病史，出现急性无痛性左眼视力损害。临床检查发现，他患有左侧视神经病变，伴有左侧视盘肿胀和充血。右侧视盘较小且拥挤，两个视盘边缘均不规则。Humphrey视野检查显示左眼视野缩小。眼底自发荧光成像显示有自发荧光，B超检查显示两个视乳头内均有高反射性。对潜在缺血和炎症标志物的血液检查显示有高脂血症证据，但其他方面正常。诊断为左侧非动脉炎性前部缺血性视神经病变（NAAION），伴有视盘玻璃疣和高脂血症。NAAION通常发生在视盘小且结构拥挤的眼睛中。视盘玻璃疣与血管危险因素并存可能会进一步增加发生NAAION的风险。
