Single intravitreal aflibercept injection for unilateral acute nonarteritic ischemic optic neuropathy.

Ziya Ayhan,Gamze Kocaoğlu,Meltem Söylev Bajin,A Osman Saatci,Aylin Yaman

doi:10.1155/2015/783241

Abstract

Acute nonarteritic ischemic optic neuropathy (ANAION) is the most common optic neuropathy in the elderly population without a well-established treatment. A 67-year-old man with a sudden painless visual loss in his left eye of one-day duration was diagnosed to have left ANAION. Next day, 2 mg aflibercept injection was injected intravitreally in OS. Visual acuity improved to 7/10 from 1/10 a week after the injection. Mean retinal nerve fiber layer thickness (RNFLT) was reduced to 159,7 μm from 182,4 μm at the first week. Visual fields improved dramatically during the follow-up of three months. The aim of this study is to present a case having ANAION treated with a single intravitreal aflibercept injection and discuss the place of intravitreal anti-VEGF injections in the treatment of armamentarium of ANAION.

Highlights

Acute nonarteritic anterior ischemic optic neuropathy (ANAION) is the most common type of optic neuropathy characterised with a sudden visual deterioration in the elderly population [1]
We report the satisfactory visual outcome obtained after the intravitreal injection of 2 mg aflibercept in a patient with unilateral ANAION
Spontaneous visual acuity improvement has been observed in 43% of patients with ANAION within six months of disease onset, but there was no visual improvement in 45% of patients and further visual deterioration was noted in 12% of cases in the control group of ischaemic optic neuropathy decompression trial [4]

Summary

Introduction

Acute nonarteritic anterior ischemic optic neuropathy (ANAION) is the most common type of optic neuropathy characterised with a sudden visual deterioration in the elderly population [1]. In 2008, Hayreh and Zimmerman [5] demonstrated that early treatment of ANAION with 80 mg oral prednisolone therapy improved both the visual acuity and visual field in their nonrandomised-controlled study. Intravitreal antivascular endothelial growth factor (VEGF) agents may be theoretically helpful as they reduce vascular permeability and thereby decrease optic nerve head oedema [9,10,11,12]. In this case report, we report the satisfactory visual outcome obtained after the intravitreal injection of 2 mg aflibercept in a patient with unilateral ANAION

Report of a Case

Findings

Discussion