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Peer-reviewedCC BY-NC-NDJournal of medical case reports

Unilateral nonarteritic anterior ischemic optic neuropathy associated with obstructive sleep apnea-hypopnea syndrome: a case report.

  1. 1Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, 730000, China.
  2. 2The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), 204 Donggang West Road, Lanzhou, 730000, China.
  3. 3Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, 730000, China. [email protected].

Abstract

Background

This report describes a case of obstructive sleep apnea-hypopnea syndrome (OSAHS) associated with nonarteritic anterior ischemic optic neuropathy (NAION). NAION is an optic neuropathy characterized by painless vision loss, visual field defects, and optic disc edema. It results from hypoperfusion of the short posterior ciliary arteries, leading to acute ischemia and structural and functional impairment of the optic nerve, which ultimately manifests as blurred vision or blindness.Case presentation

We report the case of a 59-year-old Han Chinese male who presented with a 6-day history of blurred vision and visual field defects in the left eye. The diagnosis was confirmed after excluding other potential etiologies. The patient was treated with 80 mg of oral methylprednisolone, which was gradually tapered, alongside neuroprotective and circulation-improving therapies. Following consultation with the Department of Respiratory and Sleep Medicine, he was initiated on noninvasive ventilation (NIV) to correct systemic hypoxia and received bronchodilators. Subsequently, the patient's symptoms showed moderate improvement.Discussion

NAION is frequently associated with a variety of systemic vascular risk factors, particularly hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, and cerebrovascular disease. These conditions compromise the microvascular supply to the optic nerve head, leading to ischemia, necrosis, and subsequent optic atrophy. Among these, OSAHS is recognized as a significant and independent risk factor. OSAHS is a clinical syndrome characterized by recurrent episodes of apnea and hypopnea during sleep, resulting in intermittent hypoxia, hypercapnia, and sleep fragmentation.Conclusion

OSAHS is a well-established risk factor for systemic vascular comorbidities, including cardiovascular disease and diabetes mellitus. In the present case, an association between OSAHS and NAION was observed after excluding other potential confounding etiologies. These findings highlight the clinical importance of screening for and managing OSAHS in patients with NAION, providing a rationale for optimized therapeutic strategies.

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BibTeX
@article{zhang2026unilateral,
  title = {{Unilateral nonarteritic anterior ischemic optic neuropathy associated with obstructive sleep apnea-hypopnea syndrome: a case report.}},
  author = {Chenjia Zhang and Qihang Lei and Xinzhi Song and Yuxia Fan and Xiangli Wang},
  journal = {Journal of medical case reports},
  year = {2026},
  month = sep,
  doi = {10.1186/s13256-026-06598-4},
  url = {https://europepmc.org/article/MED/42902425},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Unilateral nonarteritic anterior ischemic optic neuropathy associated with obstructive sleep apnea-hypopnea syndrome: a case report.
AU  - Chenjia Zhang
AU  - Qihang Lei
AU  - Xinzhi Song
AU  - Yuxia Fan
AU  - Xiangli Wang
PY  - 2026
DA  - 2026/09/01
JO  - Journal of medical case reports
DO  - 10.1186/s13256-026-06598-4
UR  - https://europepmc.org/article/MED/42902425
AB  - Background  This report describes a case of obstructive sleep apnea-hypopnea syndrome (OSAHS) associated with nonarteritic anterior ischemic optic neuropathy (NAION). NAION is an optic neuropathy characterized by painless vision loss, visual field defects, and optic disc edema. It results from hypoperfusion of the short posterior ciliary arteries, leading to acute ischemia and structural and functional impairment of the optic nerve, which ultimately manifests as blurred vision or blindness.Case presentation  We report the case of a 59-year-old Han Chinese male who presented with a 6-day history of blurred vision and visual field defects in the left eye. The diagnosis was confirmed after excluding other potential etiologies. The patient was treated with 80 mg of oral methylprednisolone, which was gradually tapered, alongside neuroprotective and circulation-improving therapies. Following consultation with the Department of Respiratory and Sleep Medicine, he was initiated on noninvasive ventilation (NIV) to correct systemic hypoxia and received bronchodilators. Subsequently, the patient's symptoms showed moderate improvement.Discussion  NAION is frequently associated with a variety of systemic vascular risk factors, particularly hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, and cerebrovascular disease. These conditions compromise the microvascular supply to the optic nerve head, leading to ischemia, necrosis, and subsequent optic atrophy. Among these, OSAHS is recognized as a significant and independent risk factor. OSAHS is a clinical syndrome characterized by recurrent episodes of apnea and hypopnea during sleep, resulting in intermittent hypoxia, hypercapnia, and sleep fragmentation.Conclusion  OSAHS is a well-established risk factor for systemic vascular comorbidities, including cardiovascular disease and diabetes mellitus. In the present case, an association between OSAHS and NAION was observed after excluding other potential confounding etiologies. These findings highlight the clinical importance of screening for and managing OSAHS in patients with NAION, providing a rationale for optimized therapeutic strategies.
SN  - 1752-1947
ER  -