Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy

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. Case report. A 43-year-old woman with chronic HCV infection and long-term euthyroid autoimmune thyr...

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Bibliographic Details
Published in:European journal of ophthalmology 2008-03, Vol.18 (2), p.313-315
Main Authors: Fodor, M, Nagy, V, Berta, A, Tornai, I, Pfliegler, G
Format: Article
Language:English
Subjects:
Adult
Antiviral Agents - therapeutic use
Drug Therapy, Combination
Female
Functional Laterality
Genotype
Hepacivirus - genetics
Hepacivirus - immunology
Hepacivirus - isolation & purification
Hepatitis C Antibodies - blood
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - diagnosis
Hepatitis C, Chronic - drug therapy
Humans
Interferon-alpha - therapeutic use
Optic Neuropathy, Ischemic - diagnosis
Optic Neuropathy, Ischemic - drug therapy
Optic Neuropathy, Ischemic - etiology
Polyethylene Glycols
Recombinant Proteins
Ribavirin - therapeutic use
RNA, Viral - analysis
Thyroiditis, Autoimmune - complications
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Summary: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. Case report. 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. This appears to be the first reported case of bilateral NAION presumably caused by HCV infection.
ISSN:1120-6721
1724-6016
DOI:10.1177/112067210801800226