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Non-arteritic AION in a patient with acute primary-angle closure
First Author: E. Mirza TURKEY
Co Author(s): R. Oltulu S. Belviranli G. Satirtav M. Okka
To present a case of non-arteritic ischemic optic neuropathy (NAION) secondary to acute primary-angle closure (APAC)
Department of Ophthalmology, Meram Medical Faculty, Necmettin Erbakan University, Konya ﾖ Turkey
A 49-year-old female patient admitted to our ophthalmology department because of decreased visual acuity, redness, and pain in her left eye (LE). The pre-diagnosis was APAC due to corneal edema, shallow anterior chamber (AC), middilated pupil, and elevated intraocular pressure (IOP). Topical and systemic anti-glaucoma treatment was given. Laser peripheral iridotomy (LPI) relieved pain but visual acuity of LE did not improve. Corneal edema obscured the posterior segment of LE. After, corneal edema decreased and diffuse optic disc edema was noticed in the LE. Eventually, the patient was diagnosed with NAION secondary to APAC.
At presentation, best-corrected visual acuity (BCVA) was hand motions in LE and IOP was 62 mmHg. LPI was performed and consequently AC deepened, IOP decreased to 26 mmHg, corneal edema regressed relatively. But BCVA of LE improve to just 2/10. After dilated fundus examination, it was observed that swelling of the left optic disc. The patient was diagnosed with NAION related to APAC. Intravenous pulse steroid therapy was given 3 days. After that, oral prednisone was started. Two weeks later, BCVA of the LE improved to 10/10, IOP decreased to 12 mmHg and swelling of the left optic disc regressed.
The patient was diagnosed with NAION secondary to APAC, a rare clinical entity which can result in markedly increased visual acuity.
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