A Case of Acute Nonarteritic Anterior Ischemic Optic Neuropathy in Patient on Hemodialysis

ABSTRACT

PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy (NAION) in a patient on hemodialysis. CASE SUMMARY: A 59-year-old female undergoing intravenous hemodialysis developed sudden blurred vision for 2 days. Chronic hypotension and anemia may have been persisted for approximately 6 months before the onset of symptoms. Her corrected visual acuity in both eyes was 0.7 and visual field test showed superior arcuate defect in the left eye. Fundus photography showed inferonasal optic disc swelling and fluorescein angiography revealed hyperfluorescence of the disc in the late phase which was probably attributable to NAION. After 3 weeks, corrected visual acuity was 0.7 in the left eye and fundoscopic finding of the left eye was improved. CONCLUSIONS: Hemodialysis can cause a hypotensive event and anemia which may be associated with NAION. Avoiding acute hypotension and anemia should be advised to prevent development of NAION in dialysis patients.