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Woman with Iron Deficiency Anemia and Nonarteritic Anterior Ischemic Optic Neuropathy
缺鐵性貧血女性出現前缺血性視神經病變
摘要
目的：提出一名四十七歲女性患缺鐵性貧血出現右側前缺血性視神經病變病例。 方法：病例回顧及文獻考查。 結果：一名四十七歲女性因三天以來視力下降而前來求診，本身無其它系統性疾病。眼部檢查發現右眼最佳矯正視力6/12，左眼最佳矯正視力6/6。右眼發現有相對性瞳孔反應缺損及視神經盤腫大。而自動視野檢查顯示右眼下方視野缺損，符合缺血性視神經病變，但仍未排除視神經炎之可能。實驗室抽血檢查發現其缺鐵性貧血未獲得控制。住院初其使用大劑量類固醇治療，然而視力更差至6/60。以鐵劑治療其缺鐵性貧血後，六診追蹤四個月後雖週邊視野變得更差，但右眼最佳矯正視力回復6/20。 結論：前缺血性視神經病變可能出現在較年輕但具有缺鐵性貧血之患者。
關鍵字
無資料並列摘要
Purpose: To describe a 47-year-old female with iron deficiency anemia developing nonarteritic anterior ischemic optic neuropathy (NAION). Methods: Retrospective review of medical chart and literature. A 47-year-old female without major sysremic diseases presented with blurring of vision in her right eye for 3 days. Physical defect, and disc edema OD. Anterior segment examinations were unremarkable. The left eye was normal. Automated Humphrey visual field test revealed an inferior altitudinal defect and brain computerized tomography showed on brain or orbital abnormality. Pulse steroid tomography showed no brain or orbital abnormality. Pulse steroid therapy was started for suspected optic orbital abnormlity. Pulse steroid therapy was started for suspected optic neuritis, which revised later as NAION, but persistent disc edema and progressing visual field defect were noted in follow up examinations. Laboratory studies showed hemoglobin 7.0g/dL. Ferrous sulfate was prescribed for iron deficiency anemia with normalization of hematocrit and hemoglobin, while peripheral visual field defect was progressing and the disc showed pallor change. Conclusions: NAION may occur in relatively young women with iron deficiency anemia.