Optic neuropathy associated with a Dieulafoy´s lesion

Neuropatía óptica asociada con lesión de Dieulafoy

Objective: to describe the case of a patient from Hospital de San José in Bogotá with upper gastrointestinal tract bleeding secondary to a Dieulafoy´s lesion, who presented symptoms compatible with a non-arteritic anterior ischemic optic neuropathy (NA-AION). A narrative review and systemic search of the literature was conducted to determine the clinical and demographic characteristics, treatment and visual prognosis in patients with NA-AION. Materials and methods: case report, narrative review and systematic search of the literature in Medline via Ovid and Embase databases on NA-AION secondary to hypovolemia. Sociodemographic and clinical variables, diagnosis, associated conditions, treatment and visual prognosis were analyzed. A statistical analysis was performed using absolute and relative frequencies. Results: improvement of final visual acuity in patients who presented a NA-AION episode was uncertain. In 42% there was some kind of visual acuity improvement regardless of treatment received. Vision improved in less than 50% of the reported clinical cases included in this study that received treatment with intravenous steroids. Discussion: hypovolemic NA-AION is a rare and underreported entity that may generate irreversible changes in visual acuity, so it is important to suspect and detect it to provide timely management. This case of NA-AION is one of the few described as secondary to gastrointestinal bleeding and the first associated with a Dieulafoy´s lesion.

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