Reversal of nonarteritic anterior ischemic optic neuropathy associated with coexisting primary antiphospholipid syndrome and Factor V Leiden mutation

PURPOSE: To report nonarteric anterior ischemic optic neuropathy (NAION) as an ocular manifestation in a woman with combined primary antiphospholipid syndrome and Factor V Leiden (FVL) mutation. METHODS: Case report of a middle-aged woman with hematological investigations confirming the diagnosis of both primary antiphospholipid syndrome and Factor V Leiden mutation, who presented with visual disturbance in her left eye. RESULTS: NAION was noted in her left eye. The patient was promptly treated with low molecular weight heparin, followed by warfarin, which resulted in the reversal of the ischemic optic neuropathy. CONCLUSIONS: Primary antiphospholipid syndrome and coexisting Factor V Leiden mutation should be considered in the differential diagnosis of NAION. Prompt treatment with anticoagulants can result in the reversal of the ischemic process.