LDL-apheresis in acute anterior ischemic optic neuropathy

Acute anterior ischemic optic neuropathy (AION) is a disabling disease which impairs visual function. Standard treatment is unable to affect the outcome and the visual damage persists. We describe the case of a 64-year-old patient affected by AION, whose only known risk factor was hypercholesterolem...

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Bibliographic Details
Published in:International journal of artificial organs 2004-04, Vol.27 (4), p.337-341
Main Authors: Ramunni, A, Giancipoli, G, Saracino, A, Guerriero, S, Saliani, M T, Gentile, M C, Sborgia, C, Coratelli, P
Format: Article
Language:English
Subjects:
Blood Component Removal - methods
Female
Follow-Up Studies
Humans
Hypercholesterolemia - complications
Hypercholesterolemia - diagnosis
Hypercholesterolemia - therapy
Lipoproteins, LDL - metabolism
Middle Aged
Optic Neuropathy, Ischemic - diagnosis
Optic Neuropathy, Ischemic - etiology
Optic Neuropathy, Ischemic - therapy
Risk Assessment
Severity of Illness Index
Treatment Outcome
Visual Acuity
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Summary:Acute anterior ischemic optic neuropathy (AION) is a disabling disease which impairs visual function. Standard treatment is unable to affect the outcome and the visual damage persists. We describe the case of a 64-year-old patient affected by AION, whose only known risk factor was hypercholesterolemia. After a first onset of involvement of the right eye (RE), the patient presented four weeks later with an analogous episode affecting the left eye (LE). Since standard treatment, started at involvement of the RE, had not yielded any beneficial effect, the patient underwent three sessions of LDL apheresis. The scotomatous portion of the visual field reduced even after the first session, there was further improvement after the third, and after six months the condition remained stable. Corrected vision improved from 2/10 to 6/10 after the third session. LDL cholesterol and fibrinogen decresade after the third session from 239 mg/dL to 31 mg/dL and from 289 mg/dL to 92 mg/dL, respectively. In conclusion, thanks to its effect of antagonizing hemorheologic disorders of the ocular microcirculation, LDL apheresis seems to be an efficacious treatment of AION, especially in patients suffering from hypercholesterolemia.
ISSN:0391-3988
1724-6040
DOI:10.1177/039139880402700410