Macular Involvement and Response to Steroid Therapy Demonstrated by Optical Coherence Tomography in Non-arteritic Anterior Ischaemic Optic Neuropathy

Two consecutive patients with anterior non-arteritic ischaemic optic neuropathy were evaluated with spectral-domain optical coherence tomography. The optical coherence tomographic scans revealed subfoveal fluid and intraretinal fluid extending from the optic disc margin toward the fovea that made us think that the submacular fluid appeared to arise from the peripapillary region. Fluorescein angiography showed no accumulation in the macular area, whereas leakage and staining of the optic nerve was present. After systemic corticosteroid therapy, the submacular fluid decreased promptly and the visual acuity improved. Subretinal-fluid-associated disc oedema may develop in some patients with NAION and contribute to the visual loss associated with this condition. Optical coherence tomography should be performed to follow macular involvement in patients with neuro-ophthalmic disease as well as to monitor patients' response to treatment.