Restricted Diffusion in the Optic Nerve Head After Shock-Induced Anterior Ischemic Optic Neuropathy

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Title Restricted Diffusion in the Optic Nerve Head After Shock-Induced Anterior Ischemic Optic Neuropathy
Creator Bayan A. Al Othman; Maryam Naser; Ashwini T. Kini; Andrew G. Lee
Affiliation Department of Ophthalmology (BAAO, ATK, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Ophthalmology (MN), USC Roski Eye Institute, Keck Medicine of USC, Los Angeles, California; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology (AGL), University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Ophthalmology (AGL), Texas A and M College of Medicine, Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
Abstract Shock-induced anterior ischemic optic neuropathy (SIAION) is a known type of optic neuropathy in patients who experienced shock related to different etiologies such as anemia and severe intradialytic hypotension like in our patient. Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common acute unilateral known type of optic neuropathy in older patients with vasculopathic risk factors such as hypertension, diabetes mellitus, and obstructive sleep apnea. Although SIAION and NAION are similar optic neuropathies due to ischemia and, in particular, hypotension, they may have different pathogenic mechanisms (e.g., acute shock or intradialytic hypotension vs nocturnal hypotension), laterality (e.g., unilateral vs bilateral), and severity (e.g., light perception or worse vision). We presented a case with restricted diffusion on the apparent diffusion coefficient and the diffusion weighted imaging confined to the optic disc head in a patient with pallid edema after intradialytic hypotension. Although DWI of the optic nerve is neither 100% specific nor 100% sensitive for ischemia, we believe that restricted diffusion of the optic nerve head in our case is a clinico-radiologic correlate to pallid edema in SIAION.
Subject Adult; Diffusion Magnetic Resonance Imaging; Humans; Male; Optic Disk / diagnostic imaging; Optic Neuropathy, Ischemic / diagnostic imaging
OCR Text Show
Date 2021-03
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, March 2021, Volume 41, Issue 1
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6xgc71y
Setname ehsl_novel_jno
ID 1765159
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xgc71y
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