[A case of nonarteritic anterior ischemic optic neuropathy with hypertension, diabetes mellitus, hyperlipidemia and severe stenosis of the internal carotid artery].
A 76 year-old man had had hypertension, diabetes mellitus and hyperlipidemia since 1985, and bruit in his left neck since 1993. He had abrupt decrease in left visual acuity on November 24, 2005, and visited an ophthalmologist. On November 28, his corrected visual acuity was 1.0 in the right and 0.1 in the left. The examination of optic fundi showed ear-side edema of the left optic disk. Fluorescence examination of the left optic fundus showed delay in early filling and later hyperfluorescence. Goldman visual field examination showed horizontal lower semiblindness. Since he did not complain of eye pain, his blood examination showed no reaction of inflammation, and he had hypertension, diabetes mellitus and hyperlipidemia, anterior ischemic optic neuropathy was diagnosed. The treatment with aspirin, alprostadil and prednisolone transiently improved the optic fundi and visual acuity, but his left visual acuity returned to 0.1. Carotid ultrasonography showed 95 percent stenosis in the left internal carotid artery. As there is no established treatment for ischemic optic neuropathy, the management of risk factors is most important.
Takato
Tetsuya
T
Division of Cardiovascular Disease, The Institute for Adult Diseases Asahi Life Foundation.
Ashida
Terunao
T
Yamada
Namie
N
Anai
Motonobu
M
Hori
Sadao
S
Okada
Yoshikazu
Y
D000368:Aged; D016893:Carotid Stenosis / Q000150:complications*; D048909:Diabetes Complications; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D006973:Hypertension / Q000150:complications*; D008297:Male; D018917:Optic Neuropathy, Ischemic / Q000209:etiology*