title: Nonarteritic anterior ischemic optic neuropathy associated with chronic anemia: a case series of myelodysplastic syndrome patients.
abstract: BACKGROUND
  We report on three cases of visual loss due to nonarteritic anterior ischemic optic neuropathy that developed during the course of refractory anemia, a subtype of myelodysplastic syndrome.
  
  
  METHODS
  Patients underwent fundus, visual field examination, and fluorescein angiography. A thrombophilic tendency investigation including prothrombin time, partial thromboplastin time, protein C, free protein S, and antithrombin III, polymerase chain reaction and hybridisation to allele-specific oligonucleotide probes and a bone marrow biopsy were also performed.
  
  
  RESULTS
  Relative recovery of visual function was noted in two patients, a 58-year-old man and a 67-year-old woman, whereas the vision of the third patient, a 62-year-old man, showed only marginal improvement during the follow-up period. Two patients received vigorous blood transfusion during hospitalization, while dosage adjustment of the erythropoietin infusion was decided for the third one. Thrombophilic tendency was not identified in any patient.
  
  
  CONCLUSIONS
  Chronic anemia, as presented in myelodysplastic syndrome's refractory anemia subtype, probably in the presence of additional factors, such as hypotension, is likely to be complicated by optic neuropathy, possibly through a mechanism of anemic hypoxia and/or microvascular insufficiency.
authors: Department of Ophthalmology, University of Athens, Athens, Greece.
authors: Dimitrios
authors: D
authors: Brouzas
authors: Antonios
authors: A
authors: Charakidas
authors: Ioannis
authors: I
authors: Ladas
authors: Michael
authors: M
authors: Apostolopoulos