scholarly journals Non-arteritic anterior ischaemic optic neuropathy sequential to SARS-CoV-2 virus pneumonia: preventable by endothelial protection?

2021 ◽  
Vol 14 (7) ◽  
pp. e240542
Author(s):  
Laura Moschetta ◽  
Giuseppe Fasolino ◽  
Robert W Kuijpers
Keyword(s):  
Risk Factors ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Systemic Risk ◽  
Virus Pneumonia ◽  
Ischaemic Optic Neuropathy ◽  
Optic Nerve Head Circulation ◽  
Anterior Ischaemic Optic Neuropathy ◽  
Systemic Risk Factors

We present a case of non-arteritic anterior ischaemic optic neuropathy (NAION) with no ocular or systemic risk factors in a patient who recovered from a recent SARS-CoV-2 pneumonia. NAION is the most common acute optic neuropathy among individuals over 50 years of age. It results from a transient hypoperfusion of the optic nerve head circulation, especially in patients with low vascular compliance due to ocular or systemic risk factors. We attribute the ophthalmological condition to a SARS-CoV-2 virus-associated endotheliopathy that can be prevented with timely protection of endothelial function with vitamins D and K2.

scholarly journals Non-Arteritic Anterior Ischaemic Optic Neuropathy: Treatment and Risk Factors

2020 ◽  
Vol 76 (2) ◽  
pp. 78-87
Author(s):  
Silvie Kalábová ◽  
Klára Marešová ◽  
Marta Karhanová
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Visual Acuity ◽  
Risk Factor ◽  
Optic Neuropathy ◽  
Systemic Risk ◽  
Systemic Disease ◽  
Department Of Ophthalmology ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy

Aim: To ascertain whether various therapeutic procedures in non-arteritic anterior ischaemic optic neuropathy (NAION) have an impact on the resulting visual acuity of the affected eye. To assess the prevalence of risk factors that accompany this disease according to the literature. Methods: The retrospective study enrolled 55 eyes of 53 patients (41 men, 12 women) with an age range of 46 to 85 years (mean 64.9; median 64.0) who were hospitalized at the Department of Ophthalmology of the Faculty of Medicine and Dentistry and the University Hospital in Olomouc with the diagnosis of NAION between 2005 and 2016, and who received systemic treatment with intravenous vasodilators, either alone or in combination with intravenous corticosteroids. Central visual acuity (CVA) prior to treatment and immediately after its termination was evaluated. CVA was measured using the Snellen chart and is presented in decimal values. Using medical history data and medical records, the presence of systemic disease, namely hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, was studied in these patients and evaluated for a possible association with NAION. Results: In the group of patients who were treated with intravenous vasodilators, the resulting CVA improved by 0.083 on average. In the group of patients who, in addition to vasodilator therapy, also received treatment with corticosteroids, the resulting CVA improved by only 0.03 on average. Although there was a more prominent improvement in CVA in the group treated with intravenous vasodilators alone, this difference was not statistically significant. At least one risk factor was found in the vast majority of the patients (96%). Eighty percent of the patients had hypertension, 43.6% of them were treated for diabetes mellitus, and 72.7% of the patients took drugs for hypercholesterolaemia. A combination of all these conditions was found in 36.4% of the patients. The proportion of smokers and past smokers did not exceed that of non-smokers. Conclusion: The mean improvement in the resulting CVA in patients after systemic therapy with vasodilators alone was greater than in those treated with a combination of vasodilators and corticosteroids; however, this difference was not statistically significant. In most patients in the group, at least one systemic risk factor was noted, most frequently hypertension. The prevalence rate of systemic risk factors was comparable to that reported in the literature.

scholarly journals Optic nerve head blood flow measurements in non-arteritic anterior ischaemic optic neuropathy

Eye ◽  
2000 ◽  
Vol 14 (6) ◽  
pp. 828-833 ◽  
Author(s):  
Hana Leiba ◽  
Rony Rachmiel ◽  
Alon Harris ◽  
Larry Kagemann ◽  
Ayala Pollack ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Optic Nerve Head ◽  
Flow Measurements ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy ◽  
Blood Flow Measurements

Associations between thrombophilic risk factors and determinants of atherosclerosis and inflammation in patients with non-arteritic anterior ischaemic optic neuropathy

2016 ◽  
Vol 36 (01) ◽  
pp. 46-54 ◽  
Author(s):  
C. Finger ◽  
R. B. Zotz ◽  
R. E. Scharf ◽  
R. Unsöld
Keyword(s):  
Risk Factors ◽  
Optic Neuropathy ◽  
Hdl Cholesterol ◽  
Case Control ◽  
Erythrocyte Sedimentation ◽  
Ischaemic Optic Neuropathy ◽  
Anterior Ischaemic Optic Neuropathy ◽  
Low Levels ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryNon-arteritic anterior ischaemic optic neuropathy (NAION) is caused by ischaemia of the optic nerve head. The pathophysiology of NAION is unclear, and no proven effective treatment exists. Patients, methods: We analyzed thrombophilic risk factors and determinants of atherosclerosis and inflammation in 109 consecutive patients and 109 age- and sex-matched volunteers using a case-control design. Results: High levels of fibrinogen (>384 mg/dl; OR 3.2, p = 0.003), factors VIII:C (>183%; OR 2.6, p = 0.02), IX (>153%; OR 2.6, p = 0.026), XI (>142%; OR 3.4, p = 0.006), von Willebrand factor (activity >205%; OR 3.1, p = 0.005; antigen >194%; OR 3.5, p = 0.002), and triglycerides (>228 mg/dl; OR 2.8, p = 0.026), higher platelet counts (>294 000/[uni03BC]l; OR 2.5, p = 0.04), low levels of HDL cholesterol (<40 mg/dl; OR 2.7, p = 0.032), and an accelerated erythrocyte sedimentation rate (>20 mm/h; OR 4.4, p = 0.003) were associated with NAION. Conclusion: Our findings support the contention of a complex pathogenesis of NAION resulting from the coincidence of proatherogenic, prothrombotic and proinflammatory processes. The alterations described could be causative, side effects, or just coincidental findings.

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