Bilateral non-arteritic ischemic optic neuropathy in a transsexual woman using excessive estrogen dosage.
We present a case report on a 53-year-old transsexual woman who developed acute painless vision loss in both eyes during cross-sex hormone treatment. After 10 months of cross-sex hormone treatment, she experienced total vision loss of the right eye and, 6 months later, vision loss to 20/63 in the left eye. After a full ophthalmic exam, bilateral sequential non-arteritic ischemic optic neuropathy (NA-ION) was diagnosed. Extensive etiological work-up revealed no cardiac abnormalities or inherited blood-clotting disorders. A manifest self-administered overdose of transdermal estrogen treatment with serum estradiol levels of 5,765 pg/ml was possibly related to the sequential bilateral NA-ION resulting in nearly total vision loss in this transsexual woman.
Department of Endocrinology, Ghent University Hospital, 6K12 I.E., De Pintelaan 185, 9000, Ghent, Belgium, Katrien.Wierckx@ugent.be.
Katrien
K
Wierckx
Julie
J
De Zaeytijd
Els
E
Elaut
Gunter
G
Heylens
Guy
G
T'Sjoen
D000279:Administration, Cutaneous; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis* / Q000209:etiology; D063106:Transgender Persons / Q000523:psychology; D014189:Transsexualism / Q000188:drug therapy* / Q000523:psychology; D008297:Male
D004967:Estrogens; D004958:Estradiol