Simultaneous, Bilateral Anterior Ischemic Optic Neuropathy (AION) in
Polycythemia Vera: a Case Report

Gleichzeitige, bilaterale anteriore ischämische Optikusneuropathie
(AION) bei Polyzythaemia vera: eine Falldarstellung

M. S. Tönz1, V. Rigamonti2, M. E. Iliev1
1 Department of Ophthalmology, University of Bern, Inselspital, Bern,
Switzerland
2 Department of Hematology, University of Bern, Inselspital, Bern,
Switzerland

Abstract
Background:
Polycythemia vera (PV) is a hemopoetic disorder. Apparently, although
thrombosis accounts for the majority of morbidity, AION has not been
associated with PV so far.
Patient and Findings:
A 63y-old woman with PV was hospitalized because of acute liver
failure. She also experienced bilateral painless loss of vision.
Bilateral, pale optic disc swelling with flame-like hemorrhages, more
pronounced in the right eye, constricted visual fields, and relative
afferent papillary defect (RAPD) on the right side were present.
Computer tomography scan revealed no signs of intraorbital pathology,
elevated intracranial pressure or hemorrhages.
Clinical course:
We interpreted the findings as AION associated with the hyperviscosity
syndrome. Liver transplantation had to be carried out in the next
days. Three weeks later, vision improved slightly, but RAPD persisted,
and disc pallor developed in both eyes. The patient died two months
later.
Discussion:
Central retinal artery and vein occlusions have been described as
complications of Essential thrombocythemia, but not of PV. We observed
a rare case of bilateral neuropathy suggestive of AION. This condition
has so far not been associated with PV.

Schlüsselwörter
bilaterale AION - Polyzythaemia vera - Papillenödem - Hyperviskosität
- N. opticus - Thrombose

Key words
bilateral AION - polycythemia vera - disc swelling - hyperviscosity -
optic disc - thrombosis
Kasuistik
 Klin Monatsbl Augenheilkd 2008; 225: 504-506
DOI: 10.1055/s-2008-1027304

© Georg Thieme Verlag KG Stuttgart · New York

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh

Man Is A Herbivore!
http://tinyurl.com/4rq595

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk