Twenty‐four‐hour rhythm of ocular perfusion pressure in non‐arteritic anterior ischaemic optic neuropathy

Lacharme, Tiffany; Almanjoumi, Ahmed; Aptel, Florent; Khayi, H.; Pépin, Jean‐Louis; Baguet, Jean-Philippe; Romanet, Jp; Chiquet, Christophe

doi:10.1111/aos.12352

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…IOP in the lateral position was higher than supine position [16,17,18]. Postural changing that caused IOP may be also an important risk factor for the onset of ANAION [19]. Therefore, low DBP at night, high IOP and the low OPP are the main reasons for the occurrence of ANAION in the period from falling asleep at night to getting up in the morning.…”

Section: Discussionmentioning

confidence: 97%

The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arterial Anterior Ischemic Optic Neuropathy

Wang¹,

Wang²,

Wang³

et al. 2020

Preprint

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Objective: To investigate the relationship between low ocular perfusion pressure (OPP) with acute non-arterial anterior ischemic optic neuropathy (ANAION).Methods: Forty- six patients (46 eyes) with ANAION from July 2010 to December 2016 were retrospectively analyzed. The 24-h intraocualr pressure (IOP) in sitting position was measured by non-contact tonometer. The brachial artery systolic blood pressure (SBP) and diastolic blood pressure (DBP) were simultaneously measured by electrocardiogram monitor. The 24-h OPP was calculated according to the measured blood pressure and intraocular pressure: OPP= 45% DBP-IOP. OPP< 10mmHg was defined as low OPP. Sudden visual acuity declining or visual field defect was recorded as the attack of ANAION. 24h was divided into four periods: period A (1-6 A.M), period B (6-12 A.M), period C (12-18 P.M) and period D (18-24 P.M). The correlation between low OPP and ANAION was analyzed. Statistical method was used by Person correlation analysis.Results: There was a statistical difference in the low OPP in the four periods (P< 0.05). The most common period of low OPP was period A (1-6 A.M), with the incidence of low OPP as high as 58.3%. There was a statistical difference in the incidence of ANAION in the four periods (P< 0.05). Most common time period of ANAION was also period A (1-6 A.M), with the incidence rate as high as 46.3%. Person correlation analysis showed that the period of low OPP was associated with the period of ANAION onset (r=0.934, P < 0.05).Conclusion: There was a significant clinical correlation between low OPP and ANAION. Period A (1-6 A.M) was the high-risk period for low OPP and ANAION. The occurrence of ANAION can be reduced by elevating the OPP to improve the blood perfusion of the anterior optic nerve.

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Section: Discussionmentioning

confidence: 97%

The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arterial Anterior Ischemic Optic Neuropathy

Wang¹,

Wang²,

Wang³

et al. 2020

Preprint

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show abstract

“…Reductions in nocturnal blood pressure, in conjunction with the impairment of central retinal artery blood flow and/or elevated intraocular pressures, can lead to acute ischemic events such as NAION (Fig. 4) and, more rarely, central retinal artery occlusions (CRAO) [130,131]. Among 925 episodes of NAION, 73% of patients first reported visual symptoms after waking from sleep, and nocturnal arterial hypotension showed a significant correlation with progressive visual field deterioration in NAION, altogether implying that nocturnal blood pressure depression may precipitate NAION development in patients having additional risk factors [132,133].…”

Section: Optic Nerve Vasculature: Non-arteritic Ischemic Optic Neuropathymentioning

confidence: 99%

The Associations of Obstructive Sleep Apnea and Eye Disorders: Potential Insights into Pathogenesis and Treatment

Ahn

Gorin²

2021

Curr Sleep Medicine Rep

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Purpose of Review Obstructive sleep apnea (OSA) patients are at significantly increased risks for cardiovascular and cerebrovascular morbidities. Recently, there has been heightened interest in the association of OSA with numerous ocular diseases and possible improvement of these conditions with the initiation of OSA treatment. We reviewed the current evidence with an emphasis on the overlapping pathogeneses of both diseases. Recent Findings Currently available literature points to a substantial association of OSA with ocular diseases, ranging from those involving the eyelid to optic neuropathies and retinal vascular diseases. Since the retina is one of the highest oxygen-consuming tissues in the body, the intermittent hypoxia and hypercapnia ensuing in OSA can have deleterious effects on ocular function and health. Tissue hypoxia, autonomic dysfunction, microvascular dysfunction, and inflammation all play important roles in the pathogenesis of both OSA and ocular diseases. Whether OSA treatment is capable of reversing the course of associated ocular diseases remains to be determined. It is anticipated that future therapeutic approaches will target the common underlying pathophysiologic mechanisms and promote favorable effects on the treatment of known associated ocular diseases. Summary Emerging evidence supports the association of ocular diseases with untreated OSA. Future studies focusing on whether therapeutic approaches targeting the common pathophysiologic mechanisms will be beneficial for the course of both diseases are warranted.

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“… 30 , 31 In addition, after adjustments for comorbidities, OSA patients had a significantly higher risk of developing NAION than patients without OSA over an 18-year period, with a reported hazard ratio of 1.66. 26 Thus, OSA appears to be highly prevalent among NAION patients while NAION is much less common among OSA patients. This is likely a result of the multifactorial nature of NAION including the importance of a disc-at-risk.…”

Section: Osa and Naionmentioning

confidence: 99%

<p>Neuro-Ophthalmological Manifestations of Obstructive Sleep Apnea: Current Perspectives</p>

Farahvash

Micieli

2020

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Obstructive sleep apnea (OSA) is a disease of obstructed airways during sleep that significantly impacts the quality of life and increases the risk of various systemic diseases. OSA has been studied as a risk factor for a number of neuro-ophthalmic conditions and a strong relationship has been established with non-arteritic anterior ischemic optic neuropathy (NAION). The incidence of glaucoma and stroke have also been significantly associated with OSA and are conditions that may also be seen by neuro-ophthalmologists. Patients with NAION have a significantly higher incidence of OSA and OSA diagnosis significantly increases the risk for NAION development. Non-compliance with continuous positive airway pressure (CPAP) in OSA patients has also been found to be a risk factor for fellow-eye involvement and there is increasing evidence to suggest that every patient with NAION should be formally evaluated with polysomnography. The relationship between OSA and idiopathic intracranial hypertension (IIH) has also been studied, but the relationship between these two conditions is less clear. There is insufficient evidence to recommend routine eye examinations in OSA patients for papilledema and conducting a sleep study for a newly diagnosed IIH patient should be left to the discretion of the clinician based on other symptoms and risk factors of OSA.

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Twenty‐four‐hour rhythm of ocular perfusion pressure in non‐arteritic anterior ischaemic optic neuropathy

Cited by 9 publications

References 27 publications

The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arterial Anterior Ischemic Optic Neuropathy

The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arterial Anterior Ischemic Optic Neuropathy

The Associations of Obstructive Sleep Apnea and Eye Disorders: Potential Insights into Pathogenesis and Treatment

<p>Neuro-Ophthalmological Manifestations of Obstructive Sleep Apnea: Current Perspectives</p>

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