A case of embolic non-arteritic anterior ischaemic optic neuropathy in a young patient

Abstract

We report a rare case of unilateral non-arteritic anterior ischaemic optic neuropathy (NAAION) of embolic origin in a 47-year-old male caused by hypertriglyceridaemia and significant atherosclerotic stenosis of bilateral carotid arteries. The fundus fluorescein angiogram showed features supportive of an embolic aetiology. After left carotid endarterectomy and lipid-lowering therapy, there was complete resolution of disc oedema. Embolic anterior ischaemic optic neuropathy (AION) contributes to less than 10% of total AION cases and is often underevaluated. This case report emphasises the importance of thorough systemic evaluation by the ophthalmologist in patients with AION and the role of fundus fluorescein angiography (FFA) in establishing the aetiology in AION cases.

Keywords

• anterior ischaemic optic neuropathy
• embolism
• hyperlipidaemia
• hypertriglyceridaemia