A Case of Non-Arteritic Anterior Ischemic Optic Neuropathy after Bilateral Selective Neck Dissection

ABSTRACT

PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy after bilateral selective neck dissection. CASE SUMMARY: A 48-year-old man presented with a visual field defect in his right eye 11 days after bilateral selective neck dissection. His corrected visual acuity in the right eye was 20/20; fundus photographs revealed a segmental optic disc swelling in the superior half of the right eye, and the Humphrey visual field test showed an inferior altitudinal defect in the right eye, corresponding to the disc swelling. The fluorescein angiography revealed a delayed filling on the superior half of the optic disc in the right eye. The diagnosis was non-arteritic anterior ischemic optic neuropathy. Orbital and brain MRIs showed an increase in caliber of the right optic nerve, but no other mass or enhanced lesion was noted. After 3 months, the patient's visual acuity and visual field were maintained, but segmental atrophy developed on the superior half of the right optic disc. CONCLUSIONS: With the risk factors of ischemic optic neuropathy, the possibility of postoperative visual impairment or field defect should be considered after a selective head and neck surgery.