Bilateral, nearly simultaneous anterior ischemic optic neuropathy complicated by diabetes and bilateral, small, crowded optic discs

Background: Bilateral simultaneous anterior ischemic optic neuropathy (AION) is uncommon. We report a case of bilateral and nearly simultaneously occurring AION. Case: A 61-year-old man was referred to our hospital with bilateral optic disc edema. Observations: Visual field testing demonstrated inferior nasal defect OD and inferior defect OS. Fluorescein angiography showed a delay of dye filling in the superior part of the optic disc in both eyes. The patient had poorly controlled diabetes. A mild increase in erythrocyte sedimentation rates and c-reactive protein was observed, but the results of temporal artery biopsy were negative. His optic discs were small and lacked biological cups, which has been identified as a risk factor for developing AION. Conclusions: The complications of the structural anomaly, also known as "disc at risk," and diabetes might have caused the bilateral and nearly simultaneously occurring AION.