The effect of high-dose steroids, and normobaric oxygen therapy, on recent onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial

Pakravan, Mohammad; Sanjari, Nasrin; Esfandiari, Hamed; Pakravan, Parastou; Yaseri, Mehdi

doi:10.1007/s00417-016-3451-6

Cited by 27 publications

(17 citation statements)

References 27 publications

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“…As the patients had chosen whether or not to undergo EECP treatment freely, this may have led to unrecognized bias, even though there were no significant differences regarding baseline characteristics (including the risk factors) between the two groups. Although there is no definite therapeutic window for NAION treatment, many studies have specified a 2-week window [9,31,32]. Most patients in current study had exceeded 2-week window at presentation.…”

Section: Discussionmentioning

confidence: 85%

Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy

Lin

Zhu

et al. 2020

BMC Ophthalmol

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Background: To explore the effects of enhanced external counterpulsation (EECP) and its underlying influencing factors in nonarteritic anterior ischemic optic neuropathy (NAION) patients. Methods: Patients at Zhongshan Ophthalmic Center with recent-onset (< 8 weeks) NAION were retrospectively recruited. The patients had decided whether or not they would undergo EECP treatment, and the patients who declined were included in the control group. The effectiveness of EECP was evaluated by comparing the visual function and fellow eye involvement in patients with and without EECP treatment. Results: In total, 61 patients (76 eyes) were included. Twenty-nine patients (37 eyes) underwent EECP treatment, while 32 patients (39 eyes) were included in the control group. Mean time from NAION onset to EECP initiation was 27.59 ± 16.70 days. In the EECP group, the mean EECP duration was 31.57 ± 18.45 days. EECP was well tolerated by all patients. However, there was no significant difference in visual function between the EECP and control groups. Furthermore, there was no evidence of the effectiveness of EECP in the subgroup analysis of patients with different systemic health conditions. Among the 42 patients with monocular NAION, the sequential attack rate was comparable between the EECP (27.78%) and control (25.00%) groups. Conclusion: This study is the first nonrandomized controlled study to evaluate the effectiveness of EECP in NAION patients. Unfortunately, we failed to demonstrate the effectiveness of EECP in NAION at the 6-month follow-up. Any further application of EECP in NAION patients should be cautious.

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Section: Discussionmentioning

confidence: 85%

Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy

Lin

Zhu

et al. 2020

BMC Ophthalmol

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“…[29] In fact, this early axonal swelling is the stage where timely interventions such as anti-inflammatory and neuroprotective agents proved to be promising. [14,31,32] This study has several limitations. The sample size was relatively small but is comparable to previous studies on this subject and necessitates further longitudinal studies to clarify whether choroidal thickening precedes NAION or it occurs following the ischemic incidence.…”

Section: Discussionmentioning

confidence: 96%

“…[8,9] This study is the Although the exact mechanism of NAION is yet to be understood, ischemia and the so called "compartment syndrome" in optic disc space are the main determinants for the loss of visual function. [14,15] Whatever the mechanism of vascular insufficiency in NAION, persistent hypoperfusion is required for the development of ischemic optic neuropathy. The paraoptic branches of the short posterior ciliary arteries are responsible for ONH blood supply and the infarction in NAION is suggested to be predominantly located in the retrolaminar portion of the ONH.…”

Section: Discussionmentioning

confidence: 99%

Choroidal Thickness in Acute Non-arteritic Anterior Ischemic Optic Neuropathy

Nikkhah

Feizi

Abedi

et al. 2020

JOVR

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Purpose: To compare the choroidal thickness in eyes with acute non-arteritic anterior ischemic optic neuropathy (NAION) with healthy contralateral eye and normal controls. Methods: Thirty-eight eyes with NAION, thirty-eight unaffected fellow eyes, and seventy four eyes from 37 healthy, age- and sex-matched subjects were included in this prospective comparative case-control study. Choroidal thickness was measured by enhanced depth imaging (EDI) of spectral domain optical coherence tomography (SDOCT). Peripapillary choroidal thickness (PCT) was measured at 1000 and 1500 μm from Bruch's membrane opening (BMO). Subfoveal choroidal thickness (SFCT) was measured in central subfoveal area, and 500 microns apart in temporal and nasal sides. Choroidal thickness among NAION eyes, uninvolved fellow eyes, and control eyes were compared. Results: The mean of PCT at 1000 μm was significantly thicker in NAION and fellow eyes compared to control eyes (169.7 ± 47, 154.4 ± 42.1, and 127.7 ± 49.9 μm, respectively, P < 0.001 and P = 0.42). The mean PCT at 1500 μm was also significantly thicker in NAION and fellow eyes compared to control eyes (178.6 ± 52.8, 162.6 ± 46.1, and 135.1 ± 59 μm, respectively, P = 0.007 and P = 0.048). The mean PCT at 1000 and 1500 μm was significantly greater in NAION compared to fellow eyes (P = 0.027 and P = 0.035, respectively). The mean of SFCT was significantly thicker in NAION compared to control eyes (P = 0.032); however, there was no significant difference between uninvolved fellow and control eyes (P = 0.248). Conclusion: Thicker choroidal thickness in acute NAION and uninvolved fellow eyes compared to normal eyes suggests a primary choroidal role in NAION pathophysiology.

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“…A proteína C-reativa é necessária para monitorar a atividade da doença e a resposta ao tratamento. Em situações isoladas de perda progressiva da visão, tomografia computadorizada ou ressonância nuclear magnética deve ser feita para descartar lesões compressivas [23][24][25] .…”

Section: Neuropatia óPtica Isquêmica Anteriorunclassified

“…Dessa forma, é essencial realizar uma boa avaliação clínica e tratamento dos fatores de risco, como diabetes mellitus e hipercolesterolemia, na tentativa de reduzir as chances do acometimento do outro olho. O tratamento consiste na prescrição de ácido acetilsalicílico (AAS) 23 .…”

Section: Tratamentounclassified

Perdas visuais agudas: uma revisão dos últimos 10 anos de causas não infecciosas e não maculares

2020

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Objetivo: o conhecimento das principais causas de perda visual aguda possibilita o diagnóstico precoce do paciente, o que favorece o tratamento mais rápido e eficaz, a fim de preservar a acuidade visual. Neste artigo de revisão, as principais causas não infeciosas e não oriundas da mácula são abordadas, a fim de buscar e revisar os tópicos mais pertinentes sobre cada tema, como as manifestações clínicas e os tratamentos mais utilizados. Métodos: trata-se de uma revisão de literatura, com 30 artigos selecionados e revisados da plataforma MEDLINE. Resultados: as causas de perda visual aguda discutidas são cinco. Primeiro, as por baixa acuidade visual, súbita, unilateral, sem dor e sem hiperemia: hemorragia vítrea, descolamento de retina, oclusão vascular de retina e neuropatia óptica isquêmica anterior. Posteriormente, por baixa acuidade visual, súbita, unilateral, com dor e sem hiperemia: neurite óptica. Por meio deste estudo, alguns fatores de risco podem ser evidenciados e os principais tratamentos destacados. Conclusão: o diagnóstico precoce das perdas visuais agudas deve ser realizado, com os exames físicos adequados, como a fundoscopia e os exames complementares necessários solicitados. Além disso, o encaminhamento ao oftalmologista é de extrema importância para minimizar sequelas e evitar complicações.

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The effect of high-dose steroids, and normobaric oxygen therapy, on recent onset non-arteritic anterior ischemic optic neuropathy: a randomized clinical trial

Abstract: The lack of demonstrable improvement in the structural and functional outcomes of NAION with high-dose IV steroids, or normobaric oxygen, in this randomized controlled trial calls into question the administering of systemic steroid or normobaric oxygen in this condition.

Cited by 27 publications

References 27 publications

Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy

Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy

Choroidal Thickness in Acute Non-arteritic Anterior Ischemic Optic Neuropathy

Perdas visuais agudas: uma revisão dos últimos 10 anos de causas não infecciosas e não maculares

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