Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke
An 80-year-old female with a history of diabetes mellitus (DM) and hypertension presented with sudden onset of sequential bilateral visual loss. The best visual acuity was light perception in the right eye and finger counting in the left eye, however, bilateral fundus did not reveal optic disc edema...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.988825/full |
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| author | Jin-Ju Kang Jin-Ju Kang Eun-Su Lee Haeng-Jin Lee Haeng-Jin Lee Seungbae Hwang Seungbae Hwang Myung-Ja Chung Myung-Ja Chung Sun-Young Oh Sun-Young Oh |
| author_facet | Jin-Ju Kang Jin-Ju Kang Eun-Su Lee Haeng-Jin Lee Haeng-Jin Lee Seungbae Hwang Seungbae Hwang Myung-Ja Chung Myung-Ja Chung Sun-Young Oh Sun-Young Oh |
| author_sort | Jin-Ju Kang |
| collection | DOAJ |
| description | An 80-year-old female with a history of diabetes mellitus (DM) and hypertension presented with sudden onset of sequential bilateral visual loss. The best visual acuity was light perception in the right eye and finger counting in the left eye, however, bilateral fundus did not reveal optic disc edema. Diffusion-weighted magnetic resonance imaging (MRI) of the brain revealed acute embolic stroke and diffusion restriction in the posterior portion of both optic nerves. The 24-h Holter monitor showed persistent atrial fibrillation (AF) with rapid ventricular response. The presence of painless and severe visual loss at onset unaccompanied by optic disc edema in the patient with newly detected uncontrolled AF and multiple embolic infarctions favored a diagnosis of non-arteritic posterior ischemic optic neuropathy (PION). The current case contributes to better understanding of PION pathophysiology and associated risk factors, indicating a possible relationship between non-arteritic PION and uncontrolled AF and embolic cerebral infarction. |
| first_indexed | 2024-04-11T07:47:51Z |
| format | Article |
| id | doaj.art-fa77417f6b0f41b9a3ba91181ad4eccb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T07:47:51Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fa77417f6b0f41b9a3ba91181ad4eccb2022-12-22T04:36:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-12-011310.3389/fneur.2022.988825988825Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic strokeJin-Ju Kang0Jin-Ju Kang1Eun-Su Lee2Haeng-Jin Lee3Haeng-Jin Lee4Seungbae Hwang5Seungbae Hwang6Myung-Ja Chung7Myung-Ja Chung8Sun-Young Oh9Sun-Young Oh10Department of Neurology, Jeonbuk National University Hospital and School of Medicine, Jeonju, South KoreaResearch Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South KoreaDepartment of Neurology, Jeonbuk National University Hospital and School of Medicine, Jeonju, South KoreaResearch Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South KoreaDepartment of Ophthalmology, Jeonbuk National University Hospital and School of Medicine, Jeonju, South KoreaResearch Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South KoreaDepartment of Radiology, Jeonbuk National University Hospital and School of Medicine, Jeonju, South KoreaResearch Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South KoreaDepartment of Pathology, Jeonbuk National University Hospital School of Medicine, Jeonju, South KoreaDepartment of Neurology, Jeonbuk National University Hospital and School of Medicine, Jeonju, South KoreaResearch Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South KoreaAn 80-year-old female with a history of diabetes mellitus (DM) and hypertension presented with sudden onset of sequential bilateral visual loss. The best visual acuity was light perception in the right eye and finger counting in the left eye, however, bilateral fundus did not reveal optic disc edema. Diffusion-weighted magnetic resonance imaging (MRI) of the brain revealed acute embolic stroke and diffusion restriction in the posterior portion of both optic nerves. The 24-h Holter monitor showed persistent atrial fibrillation (AF) with rapid ventricular response. The presence of painless and severe visual loss at onset unaccompanied by optic disc edema in the patient with newly detected uncontrolled AF and multiple embolic infarctions favored a diagnosis of non-arteritic posterior ischemic optic neuropathy (PION). The current case contributes to better understanding of PION pathophysiology and associated risk factors, indicating a possible relationship between non-arteritic PION and uncontrolled AF and embolic cerebral infarction.https://www.frontiersin.org/articles/10.3389/fneur.2022.988825/fullischemic optic neuropathyoptic nerveposterior ischemic optic neuropathy (PION)atrial fibrillation (AF)embolic stroke |
| spellingShingle | Jin-Ju Kang Jin-Ju Kang Eun-Su Lee Haeng-Jin Lee Haeng-Jin Lee Seungbae Hwang Seungbae Hwang Myung-Ja Chung Myung-Ja Chung Sun-Young Oh Sun-Young Oh Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke Frontiers in Neurology ischemic optic neuropathy optic nerve posterior ischemic optic neuropathy (PION) atrial fibrillation (AF) embolic stroke |
| title | Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| title_full | Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| title_fullStr | Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| title_full_unstemmed | Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| title_short | Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| title_sort | case report bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke |
| topic | ischemic optic neuropathy optic nerve posterior ischemic optic neuropathy (PION) atrial fibrillation (AF) embolic stroke |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.988825/full |
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