J Korean Ophthalmol Soc > Volume 60(12); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(12):1374-1379.
DOI: https://doi.org/10.3341/jkos.2019.60.12.1374    Published online December 15, 2019.
Nonarteritic Anterior Ischemic Optic Neuropathy with an Atypical Visual Field Defect.
Dong Hun Song, Ji Eun Lee
Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea. ddalkieco@gmail.com
비전형적 시야 이상으로 발현된 비동맥염 앞허혈시신경병증
송동훈 · 이지은
메리놀병원 안과
Correspondence:  Ji Eun Lee,
Email: ddalkieco@gmail.com
Received: 11 April 2019   • Revised: 16 May 2019   • Accepted: 6 December 2019
Abstract
PURPOSE
To report a case of nonarteritic anterior ischemic optic neuropathy (NA-AION) with an atypical visual field defect after intraocular surgery. CASE SUMMARY: A 61-year-old male presented with a visual field defect in his right eye 1 day after uneventful cataract surgery with pars plana vitrectomy for epiretinal membrane. His best-corrected visual acuity (BCVA) in the right eye was 20/400 with a relative afferent pupillary defect. A color vision test revealed failure only in the right eye. A slit-lamp examination revealed no abnormality in the anterior part of the eyes. A fundoscopic examination also revealed no abnormality in the posterior part of the eyes, including the optic disc. The Humphrey visual field test revealed a nasal vertical defect in the right eye. Orbital and brain magnetic resonance imaging were normal. After 14 days from the initial symptom, fundus photography and optical coherence tomography revealed an optic disc swelling and splinter hemorrhage. Fluorescein angiography revealed a delayed filling on the temporal half of the optic disc and inferotemporal peripapillary choroid. A diagnosis of NA-AION was made. The patient was treated with oral steroids and aspirin. After 3 months, the BCVA was 20/125. The visual field defect was maintained and segmental atrophy developed on the superior and inferior sides of the right optic disc. CONCLUSIONS: AION may present as vertical hemianopsia. With the risk factors of ischemic optic neuropathy, the possibility of AION should be considered in the differential diagnoses of postoperative visual impairments or field defects after intraocular surgery.
Key Words: Cataract surgery;Ischemic optic neuropathy;Visual field;Vitrectomy


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