Optical Coherence Tomography Angiography Acute of Non-Arteritic Anterior Ischemic Optic Neuropathy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Ahmed Hussein Ibrahim ◽  
Ahmed Abd Al Aleem Mohamed
Keyword(s):  
Optic Neuropathy ◽  
Optical Coherence Tomography Angiography ◽  
Acute Stage ◽  
Anterior Ischemic Optic Neuropathy ◽  
Control Group ◽  
Ischemic Optic Neuropathy ◽  
Outer Circle ◽  
Significant Difference ◽  
Perfusion Density ◽  
Peripapillary Area

Abstract Background Anterior ischemic optic neuropathy (AION) is divided into arteritic anterior ischemic optic neuropathy (AAION) which accounts for 15% and Nonarteritic anterior ischemic optic neuropathy (NAION) which accounts for 85% of cases. Non-arteritic anterior ischemic optic neuropathy (NAION) is an ischemic change involves the 1 mm thickness of the optic nerve head (optic disc). It affects around 10 cases per 100,000 per year in the age group over 50. Objective To assess the optical coherence tomography angiography peripapillary area pattern in diagnosed non-arteritic acute ischemic optic neuropathy patients within a period from one week to 3 weeks during (acute stage while the disc is still edematous) of acute painless diminution of vision. Patients and Methods We enrolled 20 patients in cases group and 10 patients in control group were enrolled to assess the OCTA peripapillary area pattern in diagnosed NAAION patients within a period from one week to 3 weeks during (acute stage while the disc is still edematous) of acute painless diminution of vision compared to the pattern seen in the normal control group OCTA, FFA and VF (centralized 30-2 SITA strategy) were done to the cases group. But FFA and VF were excluded in the control group. Results The results of our study show statistically significant difference found between the two studied groups regarding central circle perfusion density, middle circle perfusion density (superior, inferior and nasal) and outer circle perfusion density (superior and temporal) while no statistically significant difference found between them regarding middle circle (temporal) and outer circle (inferior and nasal). Conclusion So according to this study in cases of NAION (acute stage), we can depend on perfusion density within the middle and outer circle of Early Treatment Diabetic Retinopathy Study (ETDRS) grid put on the disc and peripapillary area. As, these are the areas affected by decreased perfusion density. While, there is increased perfusion density within the central and middle circles, which could be due to, diffuse disc edema.

scholarly journals Peripapillary and Macular Flow Changes in Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) by Optical Coherence Tomography Angiography (OCT-A)

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Zuohuizi Yi ◽  
Hongmei Zheng
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Neuropathy ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Optical Coherence ◽  
Significant Difference ◽  
Flow Changes ◽  
Sd Oct

Background. To analyze the blood flow changes of radial peripapillary capillaries (RPCs) and macula with time procession in patients with nonarteritic anterior ischemic optic neuropathy (NAION) by optical coherence tomography angiography (OCT-A). Methods. A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3–6 months after enrollment. Measures of the thickness of the peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of the RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed. Results. Compared to unaffected control eyes, wRPC ( p ≤ 0.001 ) was significantly lower in affected eyes at baseline, and there was no significant difference in wSVD ( p > 0.05 ). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1–2 and 3–6 months compared to baseline ( p = 0.001 , p ≤ 0.001 ; p ≤ 0.001 , p ≤ 0.001 ). The sRPC values were significantly lower than iRPC at 1-2/3–6 months ( p = 0.016 , p = 0.013 ), and sSVD values were lower than iSVD at 1-2 months ( p = 0.010 ). Statistically significant correlations were found between wRPC and wRNFL values at 3–6 months (r = 0.626, p = 0.022 ), between wSVD and wGCC at 1-2 weeks and 1-2 months (r = 0.570, r = 0.436; p = 0.007 , p = 0.048 ). Conclusion. OCT-A revealed a sectorial reduction in vessel density in the RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

scholarly journals Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography angiography

2020 ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Li Lu ◽  
Zuohuizi Yi ◽  
Hongmei Zheng
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Neuropathy ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Optical Coherence ◽  
Significant Difference ◽  
Sd Oct

Abstract Background To analyze the blood flow changes of radial peripapillary capillaries (RPC) and macula with time procession in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCT-A).Methods A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients, and 40 eyes of 20 healthy individuals were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3-6 months post-enrollment. Measures of the thickness of peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed.Results Compared to healthy controls, wRPC (p<0.001) and wDVD (P=0.001) were significantly lower in affected eyes at baseline, and there was no significant difference in wSVD (p>0.05). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1-2 and 3-6 months compared to baseline (p=0.001, p=0.000; p=0.000, p=0.000). The sRPC values were significantly lower than iRPC at 1-2/3-6 months (p=0.001, p=0.000), and sSVD values were lower than iSVD at 1-2 months (p=0.010). Statistically significant correlations were found between wRPC and wRNFL values at 3-6 months (r=0.626, p=0.022), between wSVD and wGCC at 1-2 weeks and 1-2 months (r=0.570, r=0.436; p=0.007, p=0.048).Conclusion OCT-A revealed a sectorial reduction in vessel density in RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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

2020 ◽  
Author(s):  
Lixia Lin ◽  
Wenhui Zhu ◽  
Nan Ma ◽  
Xiaofeng Lin ◽  
Hui Yang
Keyword(s):  
Optic Neuropathy ◽  
Visual Function ◽  
Anterior Ischemic Optic Neuropathy ◽  
Controlled Study ◽  
Control Group ◽  
Ischemic Optic Neuropathy ◽  
External Counterpulsation ◽  
Significant Difference ◽  
And Control ◽  
Enhanced External Counterpulsation

Abstract 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, regardless of time to treatment initiation. 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.

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

2020 ◽  
Author(s):  
Lixia Lin ◽  
Wenhui Zhu ◽  
Nan Ma ◽  
Xiaofeng Lin ◽  
Hui Yang
Keyword(s):  
Optic Neuropathy ◽  
Visual Function ◽  
Anterior Ischemic Optic Neuropathy ◽  
Controlled Study ◽  
Control Group ◽  
Ischemic Optic Neuropathy ◽  
External Counterpulsation ◽  
Significant Difference ◽  
And Control ◽  
Enhanced External Counterpulsation

Abstract 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, regardless of time to treatment initiation. 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.

scholarly journals Internal carotid artery velocities in patients with unilateral non-arteritic anterior ischemic optic neuropathy

2017 ◽  
Vol 15 (3) ◽  
Author(s):  
Karen Bulan Reyes
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Optic Neuropathy ◽  
Internal Carotid ◽  
Peak Systolic Velocity ◽  
Contralateral Side ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Significant Difference ◽  
Control Study

Objective: This study aims to evaluate and compare the proximal, medial, and distal segments of internal carotid artery (ICA) peak systolic velocities (PSV) in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION) in one eye against the contralateral side with normal eye findings using doppler ultrasound. Methods:  This is a single-center,  prospective, case control study of five patients with unilateral NA-AION.  The peak systolic velocity (PSV) of the proximal, medial, and distal segments of the ICAs on both sides, one side with NA-AION while the contralateral side had normal eye findings, were compared and analyzed. Results: Four females and one male with a mean age of 59 years (SD = 17 years) were included. PSV of the ICA was measured in three segments: Proximal (PICA), Medial (MICA), and Distal (DICA). Mean PSV of eyes with NA-AION was 143cm/sec (SD= 177cm/sec), 159 cm/sec (SD=189 cm/sec), 98 cm/sec (SD=34cm/sec) for PICA, MICA and DICA respectively. Mean PSV of contralateral side without NA-AION was 95cm/sec (SD= 72cm/sec), 101 cm/sec (SD=53cm/sec), 140cm/sec (SD=60 cm/sec) for PICA, MICA and DICA respectively. There was no statistically significant difference between the two groups along the three segments (T-test PICAp=0.369, MICAp=0.402, DICAp=0.112). Conclusion: Mean PSV was higher in eyes with NA-AION at the proximal and medial segments of the ICA, while it was lower at the distal segments compared to the contralateral non-NA-AION side. 

scholarly journals Retinal Vascular Changes with Non-Arteritis Anterior Ischemic Optic Neuropathy Assessed with IVAN Analysis

2020 ◽  
Author(s):  
Longli Zhang ◽  
Kaiwen Hei ◽  
Yifeng Ke ◽  
Heng Zhang ◽  
Xiaorong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optic Neuropathy ◽  
Case Control Study ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Vascular Changes ◽  
Anova Analysis ◽  
Significant Difference ◽  
Retinal Vascular Caliber ◽  
Control Study

Abstract Background To assess the vascular changes associated with non-arteritis anterior ischemic optic neuropathy (NAION) by using integrative vessel analysis (IVAN) and risk factors associated with NAION. Methods We performed a case-control study of 120 patients, including 40 NAION patients during July 2015 to July 2019. Patients were divided into Normal, hypertension and NAION groups. IVAN was conducted to evaluate the caliber of retinal vessels. In addition, we also analyzed risk factors (age, gender and BMI) to identify their association with NAION. Results 84 women and 36 men were involved in our study, the average age was 58 ± 9.98 years. CRAE, CRVE and AVR in the whole patients were 154.54 ± 21.53 µm, 252.22 ± 15.88 µm and 0.64, respectively. ANOVA analysis showed significant difference of CRAE [F (2,116) = 4.203, p = 0.017], CRVE [F (2,116) = 49.91, p < 0.001] and AVR [F (2,116) = 13.81, p < 0.0001] between each group, NAION group had wider CRAE and CRVE, while smaller AVR. BMI value showed negative correlation with CRAE in NAION group, while positively with CRVE. Conclusion Retinal vascular caliber can be used as an indicator to evaluate the NAION. Our study suggested that an assessment of retinal vascular caliber may offer insights into the development of NAION.

scholarly journals Fluoxetine for Anterior Ischemic Optic Neuropathy (AION); a Double Blind Randomized Clinical Trial

2021 ◽  
Author(s):  
Mohammad Hossein Abbasi ◽  
Shahnaz Rimaz ◽  
Zahra Pourmousa ◽  
Leila Janani ◽  
Mostafa Soltan Sanjari
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Optic Neuropathy ◽  
Study Groups ◽  
Anterior Ischemic Optic Neuropathy ◽  
Control Group ◽  
Ischemic Optic Neuropathy ◽  
Double Blind ◽  
Clinical Prognosis ◽  
Before And After

Abstract Background: Fluoxetine enhances the levels of brain-derived neurotrophic factor (BDNF); considering its known improving effects on neurogenesis and plasticity, it seems to improve the Anterior Ischemic Optic Neuropathy (AION). This study aimed to evaluate the effect of Fluoxetine on clinical prognosis of patients with AION.Methods: In this double-blind placebo-controlled randomized clinical trial, subjects with AION who were referred to Rasool Akram Hospital were divided into two study groups; the fluoxetine group that received 20 mg Fluoxetine daily(n=50) and the control group (n=50) that received placebo for a period of six months. Patients underwent clinical and paraclinical evaluations before and after the trial. This study was a registered trial with IRCT code IRCT20181109041596N1.Results: One hundred patients were enrolled from August 2019 to December 2020 and assessed in this study. Subjects in Fluoxetine group showed significant improvement in visual acuity in comparison to the placebo group with less score in LogMAR scale (P: 0.008 and 0.002, respectively), improvement in MD parameters of perimetry (P: 0.003 and 0.002, respectively), and decrease in VEP latencies (P (in 1st minute): <0.001 and <0.001, P (in 15st minute): 0.038 and 0.011, respectively). There were no differences in color vision, Rnfl in all dimensions, PSD parameter of perimetry or VEP amplitudes following the trial of Fluoxetine therapy (Ps> 0.05).Conclusion: Fluoxetine showed promising therapeutic value for patients with AION besides its safety as an additive treatment option to corticosteroids.

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