Management of Arteritic Anterior Ischemic Optic Neuropathy Post Renal Transplant

This case report helps us to understand, in a comprehensive manner, the management of anterior ischemic optic neuropathy using a multidisciplinary approach. The case taken for this study involves a young female who underwent a kidney transplant due to chronic kidney disease and presented to us with a unilateral painless loss of vision. It has been reported that prompt administration of steroids may be associated with partial recovery of the eye involved. But otherwise, the prognosis in such cases is usually poor. However, since our patient was post-renal transplant and was already taking immunosuppressive drugs, the fear of impending infections due to severely compromised immunity by both steroids and immunosuppressive therapy was there. Hence, a multidisciplinary approach was applied, involving a nephrologist, a physician, and an anesthetist as well. The recommendation for admission in a hygiene room with a dialysis facility in the hospital, monitoring of immunosuppressive therapy, and pulse-dose steroids to be started under the care of an anesthesiologist was the appropriate management.