Gong Hong-Xia, Xie Shi-Yong
Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, China.
Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.
World J Clin Cases. 2023 Sep 16;11(26):6189-6193. doi: 10.12998/wjcc.v11.i26.6189.
Non-arteritic anterior ischemic optic neuropathy (NAION) is an independent disease characterized by edematous optic discs. In eyes with branch retinal vein occlusion (BRVO), the arteries and veins in the ethmoid plate of the optic disc are relatively crowded; however, a combination of the two is clinically uncommon. Herein, we reported a patient with NAION and concealed BRVO, for which the treatment and prognosis were not similar to those for NAION alone.
Herein, we report a case of NAION with concealed BRVO that did not improve with oral medication. A week later, we switched to intravenous drug administration to improve circulation, and the patient's visual acuity and visual field recovered. Hormonal therapy was not administered throughout the study. This case suggested that: (1) Fundus fluorescein angiography (FFA) can help detect hidden BRVO along with the NAION diagnosis; (2) intravenous infusion of drugs to improve circulation has positive effects in treating such patients; and (3) NAION with concealed BRVO may not require systemic hormonal therapy, in contrast with the known treatment for simple NAION.
NAION may be associated with hidden BRVO, which can only be observed on FFA; intravenous therapy has proven effectiveness.
非动脉炎性前部缺血性视神经病变(NAION)是一种以视盘水肿为特征的独立疾病。在视网膜分支静脉阻塞(BRVO)的眼中,视盘筛板处的动静脉相对拥挤;然而,两者合并在临床上并不常见。在此,我们报告了一例患有NAION并伴有隐匿性BRVO的患者,其治疗和预后与单纯的NAION不同。
在此,我们报告一例伴有隐匿性BRVO的NAION患者,口服药物治疗无效。一周后,我们改用静脉给药以改善循环,患者的视力和视野得以恢复。在整个研究过程中未给予激素治疗。该病例表明:(1)眼底荧光血管造影(FFA)有助于在诊断NAION的同时检测隐匿性BRVO;(2)静脉输注改善循环的药物对治疗此类患者有积极作用;(3)与单纯NAION的已知治疗方法相比,伴有隐匿性BRVO的NAION可能不需要全身激素治疗。
NAION可能与隐匿性BRVO相关,后者只能在FFA上观察到;静脉治疗已被证明有效。