Nonarteritic Anterior Ischemic Optic Neuropathy Simultaneously Associated with Hashimoto’s Thyroiditis

Abstract

Purpose To report one case of nonarteritic anterior ischemic optic neuropathy (NAION) simultaneously associated with Hashimoto’s thyroiditis. Case summary A-51-year-old man with no underlying disease and painless blurring of vision in his left eye that lasted for a week visited our office. His best-corrected visual acuity was 20/20 in the right eye and 20/1,000 in the left eye. Ophthalmological examination showed a relative afferent pupillary defect in the left eye. Fundoscopic examination revealed swelling of the left optic disc; however, orbital magnetic resonance imaging was normal. Visual field testing by automated perimetry showed a dense central scotoma defect in the left eye. The possibility of optic neuritis was considered; thus, intravenous methylprednisolone (1 g/day) was initiated for 3 consecutive days. Three days after therapy, his visual field showed an inferior altitudinal defect; thus, anterior ischemic optic neuropathy was diagnosed in the left eye. Before the therapy, the anti-thyroid peroxidase antibody level was high, and Hashimoto thyroiditis was detected by thyroid ultrasonography. Conclusions This is the first reported case of NAION associated with concurrent Hashimoto’s thyroiditis. Notably, the patient had none of the risk factors associated with NAION. Keywords: Autoimmune diseases; Hashimoto’s thyroiditis; Nonarteritic anterior ischemic optic neuropathy; Optic disc swelling