Korean J Ophthalmol.  2012 Dec;26(6):473-477. 10.3341/kjo.2012.26.6.473.

Optic Disc Atrophy in Patient with Posner-Schlossman Syndrome

• Kim TH
• Kim JL
• Kee C

• KMID: 1499689
• DOI: http://doi.org/10.3341/kjo.2012.26.6.473

Abstract

A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.

Keyword

Ocular hypertension; Optic atrophy; Posner-Schlossman syndrome

MeSH Terms

Atrophy/diagnosis/etiology
Diagnosis, Differential
Glaucoma, Open-Angle/*complications/diagnosis/physiopathology
Humans
*Intraocular Pressure
Male
Optic Disk/*pathology
Optic Nerve Diseases/diagnosis/*etiology/physiopathology
Syndrome
Young Adult

Figure

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  Fig. 1 At that time of first attack, optic discs (A,B) and visual fields (C,D) of both eyes appeared normal. GHT = glaucoma hemifield test; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

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  Fig. 2 After his fifth attacks, the right optic disc (A) was pale and the left optic disc (B) showed no change. The field defect in the right eye (C) had progressed to a superior paracentral scotoma and that of the left eye (D) had no change. GHT = glaucoma hemifield test; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

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  Fig. 3 The retinal nerve fiver thickness of right eye was generally reduced compared with that of the left eye. RNFL = retinal nerve fiber layer; TEMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = right eye; OS = left eye; Imax = inferior maximum; Smax = superior maximum; Tavg = temporal average; Navg = nasal average; Max-Min = the difference value between maximum and minimum thickness; Savg = superior average; Iavg = inferior average.

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  Fig. 4 Visual evoked potential showed P100 delay in the right eye (A) compared with that of the left eye (B).

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  Fig. 5 Brain magnetic resonance image showed no abnormal findings (A,B).

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