Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy

Mariann Fodor, V. Nagy, A. Berta, I. Tornai, G. Pfliegler

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

PURPOSE. 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. METHODS. Case report. RESULTS. 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 (lshak 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. CONCLUSIONS. This appears to be the first reported case of bilateral NAION presumably caused by HCV infection.

Original languageEnglish
Pages (from-to)313-315
Number of pages3
JournalEuropean Journal of Ophthalmology
Volume18
Issue number2
Publication statusPublished - Mar 2008

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Ischemic Optic Neuropathy
Hepacivirus
Infection
Cryoglobulins
Autoimmune Thyroiditis
Anticardiolipin Antibodies
Hepatitis C Antibodies
Thrombophilia
Ribavirin
Liver
Antinuclear Antibodies
Viral RNA
Chronic Hepatitis C
Chronic Hepatitis
Hepatitis C
Transaminases
Coinfection
Interferons
Genotype
Viruses

Keywords

  • Hepatitis C
  • Nonarteritic anterior ischemic optic neuropathy
  • Thrombophilia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy. / Fodor, Mariann; Nagy, V.; Berta, A.; Tornai, I.; Pfliegler, G.

In: European Journal of Ophthalmology, Vol. 18, No. 2, 03.2008, p. 313-315.

Research output: Contribution to journalArticle

Fodor, Mariann ; Nagy, V. ; Berta, A. ; Tornai, I. ; Pfliegler, G. / Hepatitis C virus presumably associated bilateral consecutive anterior ischemic optic neuropathy. In: European Journal of Ophthalmology. 2008 ; Vol. 18, No. 2. pp. 313-315.
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AB - PURPOSE. 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. METHODS. Case report. RESULTS. 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 (lshak 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. CONCLUSIONS. This appears to be the first reported case of bilateral NAION presumably caused by HCV infection.

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