Reversal of nonarteritic anterior ischemic optic neuropathy associated with coexisting primary antiphospholipid syndrome and Factor V Leiden mutation.
OBJECTIVE
To report nonarteric anterior ischemic optic neuropathy (NAION) as an ocular manifestation in a woman with combined primary antiphospholipid syndrome and Factor V Leiden (FVL) mutation.


METHODS
Case report of a middle-aged woman with hematological investigations confirming the diagnosis of both primary antiphospholipid syndrome and Factor V Leiden mutation, who presented with visual disturbance in her left eye.


RESULTS
NAION was noted in her left eye. The patient was promptly treated with low molecular weight heparin, followed by warfarin, which resulted in the reversal of the ischemic optic neuropathy.


CONCLUSIONS
Primary antiphospholipid syndrome and coexisting Factor V Leiden mutation should be considered in the differential diagnosis of NAION. Prompt treatment with anticoagulants can result in the reversal of the ischemic process.
Srinivasan
S
S
Department of Ophthalmology, Monklands Hospital, Lanarkshire Acute Hospitals NHS Trust, Airdrie, Scotland, UK. satish@ukgateway.net
Fern
A
A
Watson
W H
WH
McColl
M D
MD
D020016:Activated Protein C Resistance / Q000150:complications*; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications*; D001167:Arteritis / Q000188:drug therapy / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005165:Factor V / Q000235:genetics*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000188:drug therapy* / Q000209:etiology; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C095381:factor V Leiden; D014859:Warfarin; D005165:Factor V