Bilateral Non-arteritic Anterior Ischaemic Optic Neuropathy as the Presentation of Systemic Amyloidosis

A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asym...

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Published inNeuro-Ophthalmology Vol. 41; no. 6; pp. 330 - 334
Main Authors Kanaan, M. Z., Lorenzi, A. R., Thampy, N., Pandit, R., Dayan, Margaret
Format Report
LanguageEnglish
Published Taylor & Francis 02.11.2017
Subjects
Giant cell arteritis
halo sign
ischaemic optic neuropathy
systemic amyloidosis
temporal artery ultrasound
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Summary:A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asymptomatic left optic disc swelling was found at routine review 2 months later, and a diagnosis of giant cell arteritis (GCA) was sought. Temporal artery duplex ultrasound showed the "halo sign," but a subsequent temporal artery biopsy showed light-chain (AL) amyloidosis with no signs of giant cell arteritis. In this case, bilateral sequential ischaemic optic neuropathy mimicking non-arteritic anterior ischaemic optic neuropathy was the presenting sign of systemic amyloidosis involving the temporal arteries.
ISSN:0165-8107
1744-506X
DOI:10.1080/01658107.2017.1328604