Syed Mohd Khomsah Syarifah Nur Humaira, Muhammed Julieana, Wan Hitam Wan-Hazabbah, Haron Juhara
Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, MYS.
Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Kota Bharu, MYS.
Cureus. 2023 Aug 18;15(8):e43722. doi: 10.7759/cureus.43722. eCollection 2023 Aug.
Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of optic neuropathy in older adults and is usually associated with an altitudinal visual field defect. Binasal hemianopia is a rare visual field presentation, and most causes are due to ocular pathology instead of brain pathology. It is an infrequent finding in NAION. We report a rare presentation of binasal hemianopia visual field defect in a patient with NAION. This a case of an elderly lady with underlying uncontrolled type 2 diabetes mellitus, hypertension, and dyslipidemia who presented with a sudden onset of painless blurring of vision in the left eye. She had a similar episode of blurred vision involving the other eye two years ago. Her visual acuity was reduced in both eyes. Humphrey visual field showed a binasal field defect. Fundoscopy showed mild hyperemic optic disc swelling in the left eye and a pale disc in the right eye. The CT scan and MRI were normal. She was co-managed with the medical team to control her systemic risk factors. Although NAION is the most common cause of optic neuropathy in older adults, binasal hemianopia is a rare visual field presentation in NAION. The history and assessment from this case add important information toward diagnosing NAION.
非动脉炎性前部缺血性视神经病变（NAION）是老年人视神经病变最常见的原因，通常与象限性视野缺损相关。双鼻侧偏盲是一种罕见的视野表现，其大多数病因是眼部病变而非脑部病变。在NAION中这是一种不常见的表现。我们报告一例NAION患者出现罕见的双鼻侧偏盲视野缺损。这是一位老年女性患者，患有未得到控制的2型糖尿病、高血压和血脂异常，因左眼突然无痛性视力模糊就诊。两年前她也曾有过类似的另一只眼视力模糊发作。她双眼视力均下降。 Humphrey视野检查显示双鼻侧视野缺损。眼底检查显示左眼视盘轻度充血肿胀，右眼视盘苍白。CT扫描和MRI均正常。她由医疗团队共同管理以控制其全身危险因素。尽管NAION是老年人视神经病变最常见的原因，但双鼻侧偏盲在NAION中是一种罕见的视野表现。该病例的病史和评估为NAION的诊断增添了重要信息。
