MACULAR EDEMA AS UNUSUAL PRESENTATION OF NON-ARTERITIC ISCHEMIC OPTIC NEUROPATHY (NAION)

Abstract

Introduction: Non-arteritic Ischemic Optic Neuropathy is the most common type of ischemic optic neuropathy. Nearly half of NAION patients presented with 20/30 or better visual acuity. Central vision is often preserved relative to the visual field loss.Macular edema in NAION patient is rare, and its occurrence may confuse to other disease and lead to unnecessary treatment. Case Report: We identified a NAION patient presented with macular edema. The patient age was above 40 and had diabetes mellitus (DM). He had clinical findings consistent with NAION with poor visual acuity at the early presentation. Optical coherence tomography examination was performed, and the patient had prominent subretinal fluid. Intravitreal antiVEGF injection was done on our patient and he showed a significant improvement of macular edema. Discussion: Macular edema is a rare clinical manifestation that may contribute a visual deterioration in NAION. The incidence of macular edema in NAION patients is difficult to measure since OCT of macula is not routinely performed. In our report, we encountered a case of NAION complicated by macular edema that underwent a different approach in therapy. Spontaneous regression of subretinal fluid was seen during observation without any treatment given. Our patient achieved a stable visual acuity and visual field defect. This finding is under the literature that spontaneous recovery will be observed during the natural course of acute NAION. Conclusion: Macular edema is an unusual but self-limiting presentation of NAION. Therefore, a comprehensive examination is needed to prevent any unnecessary treatment.