Obstructive sleep apnea caused by substernal goiter presenting as nonarteritic ischemic optic neuropathy

Excerpt

Ischemic optic neuropathy is the most common optic nerve disorder in patients over age 50 [1] and may be categorized as arteritic and nonarteritic. Nonarteritic anterior ischemic optic neuropathy (NAION) involves a loss of vision due to optic nerve infarction from insufficient blood supply and is the most common variant of ischemic optic neuropathy. There are approximately 6,000 new cases annually [2]. Substernal goiter has also been shown to be a risk factor for positional dyspnea, tracheal compression, and obstructive sleep apnea. We present a case of NAION in a normal weight male with no significant craniofacial abnormalities who likely developed obstructive sleep apnea due to a large substernal goiter ultimately resulting in bilateral NAION. …