Acute-onset non-correctable bilateral myopia in a previously healthy woman: an unexplained case

Session Details

Session Title: Paediatric Ophthalmology & Other Topics

Session Date/Time: Tuesday 25/09/2018 | 08:00-10:30

Paper Time: 09:48

Venue: Room A3, Podium 2

First Author: : D.Pavlenko UKRAINE

Co Author(s): :    T. Pavlenko                    

Abstract Details

Purpose:

The purpose is to describe a clinical case of acute-onset non-correctable bilateral myopia in a previously healthy woman.

Setting:

A 38-year-old european woman was referred to an ophthalmologist because of a 3-days history of impaired vision which she noticed after awakening in the morning. She denied any trauma, fever, stress, cough. In her previous medical records the uncorrected distance visual acuity (UDVA) of both eyes (OU) was 1.0 (20/20).

Methods:

Assessment included visual acuity test, biomicroscopy, perimetry, dilated fundus examination (DFE), ultrasonography (B-scan), optical coherence tomography (OCT) of macula and optic nerves. Also, she was consulted by a therapeutics, neurologist and a infectious disease specialist. They performed a routine blood test, biochemical blood test, coagulogram, urine test, thyroid function test, common laboratory tests for rheumatological disorders, chest X-ray, MRI of the brain, transcranial Doppler ultrasonography, abdominal ultrasonography, EKG.

Results:

During ophthalmological examination, the UDVA of both eyes was 0.3 (20/70). Autorefraktometry showed a high myopia with myopic astigmatism of both eyes (right eye (OD) was -18.62 -2.25 × 31 and left eye (OS) -17.50 -2.75 × 28). Her best-corrected visual acuity (BCVA) was as well 0.3 (20/70) with -10D lenses. Anterior segment of the eyes were normal. There was a vitreous haze 3+. There was a bilateral concentric visual field defect. Ultrasonography revealed an increased axial length: OD 28.4 mm and OS 27.4 mm. OCT revealed a slight decrease of nerve fibers in superior segments OU.

Conclusions:

Blood samples revealed leukocytosis (18700/mm3 without shift). MRI of the head revealed mild cerebral angiopathy. After detailed examination no other systemic disease was found. After the treatment (ceftriaxon, furosemide, pulse therapy of methylprednisolon, vinpocetine, vitamin B) the blood samples were normal, vitreous haze decreased to 1+, but neither UDVA nor BCVA improved. Contact lenses were prescribed (-10D) to increase sharpness. After 3 months, UDVA and BCVA revealed the same, vitreous haze was 0.5+, DFE revealed a mild paleness of optic nerve and narrowed arteries.

Financial Disclosure:

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