하시모토 갑상선염과 동반된 비동맥염성 앞허헐시신경병증

Nonarteritic Anterior Ischemic Optic Neuropathy Simultaneously Associated with Hashimoto’s Thyroiditis

Purpose: To report one case of nonarteritic anterior ischemic optic neuropathy (NAION) simultaneously associated with Hashimoto’s thyroiditis. Case summary: A-51-year-old man with no underlying disease and painless blurring of vision in his left eye that lasted for a week visited our office. His best-corrected visual acuity was 20/20 in the right eye and 20/1,000 in the left eye. Ophthalmological examination showed a relative afferent pupillary defect in the left eye. Fundoscopic examination revealed swelling of the left optic disc; however, orbital magnetic resonance imaging was normal. Visual field testing by automated perimetry showed a dense central scotoma defect in the left eye. The possibility of optic neuritis was considered; thus, intravenous methylprednisolone (1 g/day) was initiated for 3 consecutive days. Three days after therapy, his visual field showed an inferior altitudinal defect; thus, anterior ischemic optic neuropathy was diagnosed in the left eye. Before the therapy, the anti-thyroid peroxidase antibody level was high, and Hashimoto thyroiditis was detected by thyroid ultrasonography. Conclusions: This is the first reported case of NAION associated with concurrent Hashimoto’s thyroiditis. Notably, the patient had none of the risk factors associated with NAION.