Optic Nerve Head Change in Non-Arteritic Anterior Ischemic Optic Neuropathy and Its Influence on Visual Outcome

Abstract

PurposeTo evaluate changes in cup/disc (C/D) diameter ratios and parapapillary atrophy in patients with non-arteritic anterior ischemic optic neuropathy (NA-AION), using morphometric methods.MethodsThe clinical non-interventional study included 157 patients with unilateral or bilateral NA-AION. Optic disc photographs taken from both eyes at the end of follow-up were morphometrically examined.ResultsFollow-up was 86.3±70.3 months. Horizontal and vertical disc diameters (P = 0.30;P = 0.61, respectively), horizontal and vertical C/D ratios (P = 0.47;P = 0.19,resp.), and size of alpha zone and beta zone of parapapillary atrophy (P = 0.27;P = 0.32,resp.) did not differ significantly between affected eyes and contralateral normal eyes in patients with unilateral NA-AION. Similarly, horizontal and vertical disc diameters, horizontal and vertical C/D ratios, and size of alpha zone and beta zone did not vary significantly (all P>0.05) between the unaffected eyes of patients with unilateral NA-AION and the eyes of patients with bilateral NA-AION. Optic disc diameters, C/D ratios, size of alpha zone or beta zone of parapapillary atrophy were not significantly associated with final visual outcome in the eyes affected with NA-AION (all P>0.20) nor with the difference in final visual acuity between affected eyes and unaffected eyes in patients with unilateral NA-AION (all P>0.25).ConclusionsNA-AION did not affect C/D ratios nor alpha zone and beta zone of parapapillary atrophy. Optic disc size was not related to the final visual acuity outcome in NA-AION.

Bruch's membrane opening changes and lamina cribrosa displacement in non-arteritic anterior ischaemic optic neuropathy

“…Recently, Jonas et al 18 reported that NAION did not affect parapapillary atrophy. However, to the best of our knowledge, deeper ONH structures have not been studied in patients with NAION.…”

Comparison of Optic Nerve Head Morphology in Patients with Primary Open Angle Glaucoma and Non-Arteritic Anterior Ischemic Optic Neuropathy

“…It is possible that diff erence in the structure of extracellular matrix infl uences the stability of laminar region. Vascular supply of ONH in the eyes with POAG passes vertically (60% of cases) through temporal part of the papilla and is more sensitive to ischemia when the perfusion pressure decreases 26,27 . In the eyes with NAION, segmental excesses probably occur due to anatomic division of the microvasculature supplying the ONH into distinct upper and lower halves.…”

Optical coherence tomography angiography in acute non-arteritic anterior ischaemic optic neuropathy

“…If the visual acuity did not allow evaluation with Humphrey perimetry, patients underwent Goldmann perimetry (I-2e, I-4e and IV-4e targets). The optic disc photographs of both eyes of the patients in this study were digitised, and the horizontal and vertical optic disc diameters were measured 22 23…”