A case of non-arteritic anterior ischemic optic neuropathy after completion of Harvoni therapy

Abstract

Purpose: To report the first reported case of non-arteritic anterior ischemic optic neuropathy (NAION) associated with the use of Harvoni (Gilead Sciences, Foster City, CA, USA), a newly approved treatment for Hepatitis C.

Observations: We report a case of NAION in a hepatitis C patient who completed Harvoni therapy just prior to presentation. Harvoni was suspected to be the causative agent given a lack of NAION risk factors in an otherwise healthy young patient.

Conclusions and importance: NAION is an acute, painless vision loss that typically affects adults over 50. The mechanism of NAION remains uncertain although numerous associations have been identified including certain medications. Harvoni, a combination drug of ledipasvir/sofosbuvir, is a recently FDA-approved treatment for Hepatitis C. To date, however, no ophthalmological side effects have been reported with its use. Continued surveillance of patients treated with Harvoni will be needed to determine if additional events are observed in the future.

Keywords: Harvoni; Ischemic optic neuropathy; NAION.

Figures

Fig. 1

– Fundus Photos at Presentation and Two Month Follow-up. Fundus photo at two weeks (top) showing “disc at risk” right eye and hemorrhagic swelling of optic disc left eye with cotton wool spots at the disk and retinal venular engorgement. Fundus photo at two months (bottom) showing “disc at risk” right eye and marked pallor of optic disc left eye.

Fig. 2

– Humphrey Visual Field at Presentation. Humphrey visual field shows unremarkable right eye and global constriction left eye.