Case report

Central retinal artery occlusion and non-arteritic anterior ischemic optic neuropathy associated with an overlap syndrome: a case report

Verônica C Lima¹ , Tiago S Prata^2,3 , Jeffrey M Liebmann^2,4,5 and Robert Ritch^2,6

¹  Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY, USA

²  Einhorn Clinical Research Center, The New York Eye and Ear Infirmary, New York, NY, USA

³  Glaucoma Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003, USA

⁴  Manhattan Eye, Ear and Throat Hospital, New York, NY, USA

⁵  New York University School of Medicine, New York, NY, USA

⁶  New York Medical College, Valhalla, NY, USA

author email corresponding author email

Journal of Medical Case Reports 2008, 2:389doi:10.1186/1752-1947-2-389

Published:	17 December 2008

Abstract

Introduction

An "overlap syndrome" is defined as the sequential appearance over time of two or more risk factors for glaucomatous damage. The appearance of a new risk factor can alter the course and prognosis of previously stable disease. Exfoliation syndrome is a leading cause of glaucoma and is associated with vascular disease. We report a case of central retinal artery occlusion and non-arteritic anterior ischemic optic neuropathy in a patient with overlap syndrome.

Case presentation

An 87-year-old woman with longstanding stable primary open-angle glaucoma developed bilateral exfoliation syndrome, after which her intraocular pressure became uncontrolled and her glaucomatous damage progressed rapidly. She also developed ischemic arterial events in both eyes.

Conclusion

The case presented here shows that overlap syndromes can lead to rapid, irreversible vision impairment. To the best of our knowledge, this is the first reported case of central retinal artery occlusion and non-arteritic anterior ischemic optic neuropathy in a patient with overlap syndrome.