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Abstract #20824 Published in IGR 10-1

Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy

Fodor M; Nagy V; Berta A; Tornai I; Pfliegler G
European Journal of Ophthalmology 2008; 18: 313-315


PURPOSE. To report a case of bilateral nonarteritic anterior ischemic optic neuropathy (NAION) in a hepatitis C (HCV) infected patient and demonstrate the relationship between HCV and the development of NAION. METHODS. Case report. RESULTS. A 43-year-old woman with chronic HCV infection and long-term euthyroid autoimmune thyroiditis suddenly lost vision in her right eye, and 6 months later in her left eye, due to NAION. Slightly elevated levels of aminotransferases suggested liver infection activity. Anti-HCV antibody was detected; the genotype of the virus was 1b and the viral RNA level was 1.8 x 106 IU/mL. Liver biopsy proved chronic active hepatitis (Ishak score grading: 7, staging: 2). Except for the elevated levels of antithyroid antibodies and a weak antinuclear factor, the detailed laboratory examinations (thrombophilia, cryoglobulin, anticardiolipin antibodies, co-infections) revealed no other abnormalities; a causative relationship between the underlying chronic hepatitis C and bilateral NAION therefore seems probable. The patient was treated with pegylated interferon and ribavirin for 1 year and a sustained viral remission could be achieved. Her vision has neither improved nor deteriorated further. CONCLUSIONS. This appears to be the first reported case of bilateral NAION presumably caused by HCV infection.

Dr. M. Fodor, Department of Ophthalmology, Medical and Health Sciences Center, Faculty of Medicine, University of Debrecen, Debrecen, Hungary


Classification:

10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy



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