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Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography.

Abstract：

PURPOSE:To study the characteristics of nonarteritic anterior ischemic optic neuropathy (NAION) as measured with optical coherence tomography (OCT) at diagnosis and during the first year after the episode. DESIGN:Cohort study. PARTICIPANTS:Twenty-seven patients diagnosed with NAION in our center between April 1, 2004 and March 31, 2006. METHODS:Patients diagnosed with NAION underwent at the time of diagnosis and 6 weeks and 3, 6, and 12 months after presentation a complete ophthalmologic evaluation, including determination of Snellen visual acuity (VA), visual fields (VFs) (standard automated perimetry, Swedish Interactive Threshold Algorithm strategy 24-2), and optic nerve head (ONH) scanning with StratusOCT. MAIN OUTCOME MEASURES:Characteristics of the ONH and their relationship with VA and VFs. RESULTS:Initial mean retinal nerve fiber layer (RNFL) thickness in the affected eye was 200.9 microm (standard deviation [SD], 52.3 microm); this represented a 96.4% increase relative to the fellow eye. Percentages of RNFL loss 3, 6, and 12 months after onset were 38.9%, 42.3%, and 43.9%, respectively. At the 6-month visit, RNFL percentage decreases for the superior, nasal, inferior, and temporal quadrants were 51.5%, 28.5%, 41.2%, and 38.2%, respectively. Reduction in the superior quadrant RNFL thickness was statistically higher. Using regression analysis, it was found that for every micrometer of mean RNFL thickness lost there was a 2-decibel decrease in VF mean deviation (MD) and that there was a 1-line drop in Snellen VA for every 1.6 microm lost. The mean ONH area was 2.6 mm2 (SD, 0.4) in the unaffected eye; there was no correlation with VA, VF MD, or RNFL thickness of the affected eye at the last follow-up visit. CONCLUSIONS:Optical coherence tomography can diagnose optic disc edema and monitor RNFL loss over time. It is most useful at onset and 6 months after NAION, when RNFL loss has reached a plateau and is correlated with visual function. Future studies that aim to determine if a drug or intervention is useful for treating NAION may include OCT assessment of the RNFL thickness, because it provides an objective outcome measure correlated with visual performance.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Contreras I,Noval S,Rebolleda G,Muñoz-Negrete FJ

doi

10.1016/j.ophtha.2007.05.042

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

2338-44

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(07)00599-4

journal_volume

114

pub_type

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Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography.