Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient
Introduction. Non-arteritic anterior ischemic optic neuropathy (NAION) is typically manifested by sudden, pain-less vision loss in one eye, often immediately upon waking up. The visual loss remains fairly stable over time but can be followed by similar manifestations in the fellow eye. One of the ma...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2025-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500028K.pdf |
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| author | Katanić-Pasovski Katarina Popević Martin Pasovski Viktor Petrović-Pajić Sanja Iklozan Kristina Rančić Nemanja Resan Mirko Raičević Ranko |
| author_facet | Katanić-Pasovski Katarina Popević Martin Pasovski Viktor Petrović-Pajić Sanja Iklozan Kristina Rančić Nemanja Resan Mirko Raičević Ranko |
| author_sort | Katanić-Pasovski Katarina |
| collection | DOAJ |
| description | Introduction. Non-arteritic anterior ischemic optic neuropathy (NAION) is typically manifested by sudden, pain-less vision loss in one eye, often immediately upon waking up. The visual loss remains fairly stable over time but can be followed by similar manifestations in the fellow eye. One of the main causes for NAION is impaired hemodynamic regulation, followed by hypoperfusion of the optic nerve head. Recognized risk factors include arterial hyper-tension, hyperlipidemia, diabetes mellitus, smoking, etc. Case report. A 43-year-old man with a sudden painless right eye vision loss and typical symptoms and signs of NAION is presented. The ophthalmological examination, followed by fluorescein angiography and visual field testing, confirmed the diagnosis, while medical history had not revealed any of the standard risk factors. During hospitalization, the medical staff noted that the patient was snoring, waking up during the night while feeling short of breath, followed by excessive daytime sleepiness, which was later confirmed by family members as symptoms that had been present for several months. The patient was referred to a somnologist, who, after diagnostics, confirmed the presence of severe, untreated obstructive sleep apnea (OSA) and indicated treatment with a continuous positive air pressure (CPAP) device. The patient responded well to treatment, showing subjective and objective improvements in sleep quantity and quality. No progression of right eye NAION or vision impairments in the left eye has been noted after 6 months from diagnosis and CPAP introduction. Conclusion. OSA was probably the main underlying cause of NAION in this patient. We point out that OSA screening in high-risk patients can contribute to the early diagnosis and prevention of NAION. |
| format | Article |
| id | doaj-art-d37ec92f32f242c1b39d4efc941a7a97 |
| institution | Matheson Library |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-d37ec92f32f242c1b39d4efc941a7a972025-07-29T13:10:50ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202025-01-0182637438010.2298/VSP241219028K0042-84502500028KUnrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patientKatanić-Pasovski Katarina0https://orcid.org/0000-0002-7573-8507Popević Martin1https://orcid.org/0000-0001-9853-4366Pasovski Viktor2https://orcid.org/0009-0005-7456-4444Petrović-Pajić Sanja3https://orcid.org/0000-0003-1568-8322Iklozan Kristina4Rančić Nemanja5https://orcid.org/0000-0002-5122-8094Resan Mirko6https://orcid.org/0000-0002-6730-9630Raičević Ranko7Military Medical Academy, Clinic for Ophthalmology, Belgrade, SerbiaMilitary Medical Academy, Institute of Occupational Medicine, Belgrade, SerbiaMilitary Medical Academy, Clinic for Neurology, Belgrade, SerbiaClinic for Eye Diseases, University Clinical Center of Serbia, Belgrade, SerbiaMilitary Medical Academy, Clinic for Neurology, Belgrade, SerbiaMilitary Medical Academy, Center for Clinical Pharmacology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Ophthalmology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Neurology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaIntroduction. Non-arteritic anterior ischemic optic neuropathy (NAION) is typically manifested by sudden, pain-less vision loss in one eye, often immediately upon waking up. The visual loss remains fairly stable over time but can be followed by similar manifestations in the fellow eye. One of the main causes for NAION is impaired hemodynamic regulation, followed by hypoperfusion of the optic nerve head. Recognized risk factors include arterial hyper-tension, hyperlipidemia, diabetes mellitus, smoking, etc. Case report. A 43-year-old man with a sudden painless right eye vision loss and typical symptoms and signs of NAION is presented. The ophthalmological examination, followed by fluorescein angiography and visual field testing, confirmed the diagnosis, while medical history had not revealed any of the standard risk factors. During hospitalization, the medical staff noted that the patient was snoring, waking up during the night while feeling short of breath, followed by excessive daytime sleepiness, which was later confirmed by family members as symptoms that had been present for several months. The patient was referred to a somnologist, who, after diagnostics, confirmed the presence of severe, untreated obstructive sleep apnea (OSA) and indicated treatment with a continuous positive air pressure (CPAP) device. The patient responded well to treatment, showing subjective and objective improvements in sleep quantity and quality. No progression of right eye NAION or vision impairments in the left eye has been noted after 6 months from diagnosis and CPAP introduction. Conclusion. OSA was probably the main underlying cause of NAION in this patient. We point out that OSA screening in high-risk patients can contribute to the early diagnosis and prevention of NAION.https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500028K.pdfdiagnosisoptic neuropathyischemicrisk factorssleep apneaobstructive |
| spellingShingle | Katanić-Pasovski Katarina Popević Martin Pasovski Viktor Petrović-Pajić Sanja Iklozan Kristina Rančić Nemanja Resan Mirko Raičević Ranko Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient Vojnosanitetski Pregled diagnosis optic neuropathy ischemic risk factors sleep apnea obstructive |
| title | Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| title_full | Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| title_fullStr | Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| title_full_unstemmed | Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| title_short | Unrecognized severe obstructive sleep apnea as a dominant risk factor for non-arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| title_sort | unrecognized severe obstructive sleep apnea as a dominant risk factor for non arteritic anterior ischemic optic neuropathy in an apparently healthy patient |
| topic | diagnosis optic neuropathy ischemic risk factors sleep apnea obstructive |
| url | https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500028K.pdf |
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