Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2023; 11(26): 6189-6193
Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6189
Non-arteritic anterior ischemic optic neuropathy combined with branch retinal vein obstruction: A case report
Hong-Xia Gong, Shi-Yong Xie
Hong-Xia Gong, Shi-Yong Xie, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, China
Hong-Xia Gong, Shi-Yong Xie, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
Hong-Xia Gong, Shi-Yong Xie, Neuroophthalmology, Nankai University Affiliated Eye Hospital, Tianjin 300020, China
Author contributions: Gong HX contributed to manuscript writing, editing, and data collection; Xie SY contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Xia Gong, Doctor, Chief Physician, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin 300020, China. ghx13512908433@163.com
Received: April 28, 2023
Peer-review started: April 28, 2023
First decision: July 3, 2023
Revised: July 16, 2023
Accepted: August 17, 2023
Article in press: August 17, 2023
Published online: September 16, 2023
Processing time: 133 Days and 2.2 Hours
Abstract
BACKGROUND

Non-arteritic anterior ischemic optic neuropathy (NAION) is an independent disease characterized by edematous optic discs. In eyes with branch retinal vein occlusion (BRVO), the arteries and veins in the ethmoid plate of the optic disc are relatively crowded; however, a combination of the two is clinically uncommon. Herein, we reported a patient with NAION and concealed BRVO, for which the treatment and prognosis were not similar to those for NAION alone.

CASE SUMMARY

Herein, we report a case of NAION with concealed BRVO that did not improve with oral medication. A week later, we switched to intravenous drug administration to improve circulation, and the patient’s visual acuity and visual field recovered. Hormonal therapy was not administered throughout the study. This case suggested that: (1) Fundus fluorescein angiography (FFA) can help detect hidden BRVO along with the NAION diagnosis; (2) intravenous infusion of drugs to improve circulation has positive effects in treating such patients; and (3) NAION with concealed BRVO may not require systemic hormonal therapy, in contrast with the known treatment for simple NAION.

CONCLUSION

NAION may be associated with hidden BRVO, which can only be observed on FFA; intravenous therapy has proven effectiveness.

Keywords: Non-arteritic anterior ischemic optic neuropathy; Branch retinal vein occlusion; Fundus fluorescein angiography; Field; Vision; Prognosis; Case report

Core Tip: Herein, we report a case of non-arteritic anterior ischemic optic neuropathy (NAION) complicated by concealed branch retinal vein occlusion (BRVO). Visual function recovered following an intravenous drip of circulatory drugs. This suggests that: (1) Fundus fluorescein angiography can help detect hidden BRVO; (2) the intravenous administration of drugs to improve circulation has positive effects in such patients; and (3) these patients may not require systemic hormonal therapy. These concepts differ from the concepts adopted regarding the treatment and prognosis of the previously reported simple NAION.