Bilateral Optic Disc Edema Associated with Hypocalcemia.

Heo, Dong Won; Kim, Jung Yeul; Lee, Yeon Hee

doi:2017.58.5.620

J Korean Ophthalmol Soc > Volume 58(5); 2017 > Article

Case Report

Journal of the Korean Ophthalmological Society 2017;58(5):620-625.
DOI: https://doi.org/10.3341/jkos.2017.58.5.620 Published online May 15, 2017.

Bilateral Optic Disc Edema Associated with Hypocalcemia.

Dong Won Heo, Jung Yeul Kim, Yeon Hee Lee

Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea. opticalyh@hanmail.net

저칼슘혈증과 연관된 양안 시신경유두의 부종

허동원⋅김정열⋅이연희

충남대학교 의과대학 안과학교실

Correspondence: Yeon-Hee Lee, MD, PhD
Email: opticalyh@hanmail.net

Received: 12 January 2017 • Revised: 7 March 2017 • Accepted: 18 April 2017

Abstract

PURPOSE
To report a case of bilateral optic disc edema associated with hypocalcemia. CASE SUMMARY: A 48-year-old woman visited our ophthalmology department with decreased vision and disturbance of the visual field in the right eye, which began 2 days prior to presentation. The patient history indicated she had undergone total thyroidectomy 3 months prior and was given an oral calcium preparation. She had no eye pain, headache, tinnitus or diplopia. Her best corrected visual acuity of both eyes was 1.0, and color vision was normal in both eyes although a mild relative afferent pupillary defect was present in the right eye. Severe bilateral optic disc edema was present in the right eye. A Humphrey visual field test revealed an enlarged blind spot and peripheral nasal step scotoma in the right eye. The Cerebrospinal fluid (CSF) opening pressure was within the normal range and there were no abnormal findings regarding CSF. Additionally, there were no remarkable findings on brain magnetic resonance imaging nor neurologic tests. Her serum calcium was 5.9 mg/dL (normal range: total calcium 8.7-10.6 mg/dL), and an intravenous calcium supplement was started. Visual disturbance and optic disc edema improved 2 days after replacement and the optic disc edema completely dissolved 2 months later. CONCLUSIONS: Hypocalcemia may cause bilateral optic disc edema and can be recovered through adequate calcium supplementation, and it is necessary to prevent and promptly detect this rare complication.

Key Words: Disc swelling;Hypocalcemia;Optic neuropathy;Papilledema