Bilateral, Nearly Simultaneous Anterior Ischemic Optic Neuropathy Complicated by Diabetes and Bilateral, Small, Crowded Optic Discs

Abstract

Bilateral simultaneous anterior ischemic optic neuropathy (AION) is uncommon. We report a case of bilateral and nearly simultaneously occurring AION. A 61-year-old man was referred to our hospital with bilateral optic disc edema. Visual field testing demonstrated inferior nasal defect OD and inferior defect OS. Fluorescein angiography showed a delay of dye filling in the superior part of the optic disc in both eyes. The patient had poorly controlled diabetes. A mild increase in erythrocyte sedimentation rates and creactive protein was observed, but the results of temporal artery biopsy were negative. His optic discs were small and lacked biological cups, which has been identified as a risk factor for developing AION. The complications of the structural anomaly, also known as "disc at risk," and diabetes might have caused the bilateral and nearly simultaneously occurring AION.