RESUMO
We report a case of anterior ischemic optic neuropathy associated with udenafil. A 54-year-old male presented with an acute onset visual field defect of the right eye after udenafil use. Examination revealed a relative afferent pupillary defect and a swollen disc. Automated visual fields revealed an enlarged blind spot and a narrowed visual field. Fluorescein angiography revealed both an inferior choroidal filling delay and an inferior sector filling delay of the optic disc in the arteriovenous phase as well as diffuse leakage of the optic disc in the late phase. Optical coherent tomography revealed increased thickness of the retinal nerve fiber layer, especially in the area of the inferior disc. The patient was counseled to discontinue the use of udenafil and to monitor his blood pressure regularly. The disc swelling was resolved with residual optic atrophy one month after discontinuing the use of udenafil.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doença Aguda , Corioide/patologia , Neuropatia Óptica Isquêmica/induzido quimicamente , Inibidores da Fosfodiesterase 5/efeitos adversos , Pirimidinas/efeitos adversos , Sulfonamidas/efeitos adversos , Tomografia de Coerência Óptica , Campos VisuaisRESUMO
PURPOSE: To report a case of complete recovery within 1 day of cortical blindness associated with electroconvulsive therapy (ECT). CASE SUMMARY: A 15-year-old girl, who had no ophthalmologic disease, complained of bilateral visual loss immediately after ECT. At the first ophthalmologic examination, best corrected visual acuity was 0.03 in both eyes. Findings of anterior segment and fundus, movement of external ocular muscles, and pupillary light reflex were normal. Visual field examination showed generalized reduction of sensitivity and increased fixation loss in both eyes. Optical coherence tomography revealed no abnormalities. Electroretinography was normal, and a slightly prolonged latency of P100 was noted in the right and left flash visual evoked potentials. Without any specific treatment, the patient's vision improved gradually after 18 hours of ECT and was recovered completely, with vision of 1.0 in both eyes the next day. There were no abnormalities in visual evoked potentials or the visual field. CONCLUSIONS: Transient visual loss can occur after ECT, because of cortical blindness by transient cerebral ischemia, and can be recovered completely without specific treatment.