A case of anterior ischemic optic neuropathy associated with dysplasminogenemia

We report a case of anterior ischemic optic neuropathy associated with dysplasminogenemia. The patient, a 67-year-old male, complained of superior visual field defect and visual loss, first in his left eye, and 18 months later in his right. Despite treatment with fibrinolytic drug and corticosteroid, light sense in his left eye was lost and right visual acuity diminished to finger count. From this history, and from clinical findings, such as optic disc edema and dye leakage from optic disc in fluorescein fundus angiography, we diagnosed this case as anterior ischemic optic neuropathy. In addition to the optic disk abnormalities, arteriosclerotic changes were found in the retinal vessels. Laboratory examination revealed a low level of plasminogen activity in the plasma, but a normal concentration of plasminogen antigen. These results suggest that circulatory disturbance can occur in patients with dysplasminogenemia when risk factors such as arteriosclerosis are associated.