Non-Arteritic Anterior Ischaemic Optic Neuropathy: A New Indication for Carotid Endarterectomy

We present a case of non-arteritic anterior ischaemic optic neuropathy (NAION) associated with ipsilateral internal carotid artery stenosis, in a patient who presented with sudden loss of vision. This patient underwent a carotid endarterectomy and reported both subjective and objective improvement in vision in the immediate postoperative period and a complete resolution of symptoms at 6 weeks follow-up. This case raises the question of a new indication for carotid endarter-ectomy in selected cases of NAION.

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Research on Association of the Diameter of the Internal Carotid Artery Siphon and Nonarteritic Anterior Ischaemic Optic Neuropathy

Journal of Ophthalmology ◽

10.1155/2019/7910602 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Zhiyong Fu ◽

Hongyang Li ◽

Wei Wang ◽

Yanling Wang

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Optic Neuropathy ◽

Internal Carotid ◽

Resistance Index ◽

Control Group ◽

Observation Group ◽

Significant Difference ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

Objective. To investigate the association of the diameter of the internal carotid artery siphon (ICAS) and nonarteritic anterior ischaemic optic neuropathy (NAION). Methods. Thirty patients clinically diagnosed with NAION (unilateral affected) who presented to Beijing Friendship Hospital from January 2017 to October 2018 were selected. The eyes suffered from NAION were enrolled as the observation group, and the fellow healthy eyes were enrolled as the control group. The following indexes were measured: diameter of the ICAS and the ophthalmic artery (OA), intima-media thickness (IMT) of the internal carotid artery (ICA), degree of stenosis of the ICA and plaque formation, and hemodynamic parameters of the ICA and the short posterior ciliary arteries (SPCAs). All the values were compared between the two groups. Results. The diameter of the ICAS in the observation group (0.30 ± 0.07 cm) significantly narrowed compared with that of the control group (0.32 ± 0.06 cm) (P<0.05), but the diameter of the OA of the two groups had no significant difference. The detection rate of carotid atherosclerosis plaque, the average blood flow velocity (Vm), and the resistance index (RI) of the ICA in the observation group (46.67%, 26.81 ± 1.78 cm/s, and 0.72 ± 0.06) had significant differences compared with those of the control group (16.67%, 28.19 ± 2.75 cm/s, and 0.70 ± 0.05) (P<0.05), but the gradings of ICA stenosis and IMT between the two groups had no significant differences. The peak systolic velocity (PSV) and the end diastolic velocity (EDV) of the SPCAs in the observation group (10.72 ± 2.88 cm/s and 3.43 ± 1.01 cm/s) were significantly lower than those of the control group (13.62 ± 3.93 cm/s and 4.59 ± 1.71 cm/s) (P<0.05), but the RI of the SPCAs of the two groups had no significant differences. Conclusion. The diameter of the ICAS has a close relationship with NAION.

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Carotid Endarterectomy in Octogenarians with Symptomatic High-Grade Internal Carotid Artery Stenosis: Long-Term Clinical and Duplex Follow-up

Vascular and Endovascular Surgery ◽

10.1177/153857440203600601 ◽

2002 ◽

Vol 36 (6) ◽

pp. 409-414 ◽

Cited By ~ 9

Author(s):

R. Metz ◽

J. A. W. Teijink ◽

H. D. W. M. van de Pavoordt ◽

R. G. A. Ackerstaff ◽

G. J. de Borst ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Carotid Endarterectomy ◽

Carotid Artery Stenosis ◽

Internal Carotid ◽

Internal Carotid Artery Stenosis ◽

Artery Stenosis ◽

High Grade

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Loss of vision in a bleeding peptic ulcer patient following resuscitation - an unusual cause of non-arteritic anterior ischaemic optic neuropathy

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v26i1.4234 ◽

1970 ◽

Vol 26 (1) ◽

pp. 50-54

Author(s):

Md Shafayet Hasan Majumder

Keyword(s):

Peptic Ulcer ◽

Optic Neuropathy ◽

Ulcer Patient ◽

Peptic Ulcer Patient ◽

Sudden Loss ◽

Ulcer Disease ◽

Loss Of Vision ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy ◽

Bilateral Papilloedema

A 55-year old male, known to have peptic ulcer disease for 4 years, started haematamesis and melaena in a rural area of Bangladesh and was admitted into hospital with circulatory collapse. He was resuscitated with 8 units of whole blood transfusion and became stable. But he developed sudden loss of vision and fundoscopy revealed bilateral papilloedema but CT scan appeared normal. Clinical and ophthalmological evaluation was consistent with non-arteritic anterior ischaemic optic neuropathy. Key words: optic neuropathy; peptic ulcer DOI: 10.3329/jbcps.v26i1.4234 J Bangladesh Coll Phys Surg 2008; 26: 50-54

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Non-arteritic anterior ischaemic optic neuropathy: A new indication for carotid endarterectomy

Phlebology The Journal of Venous Disease ◽

10.1007/bf02638607 ◽

2002 ◽

Vol 17 (3-4) ◽

pp. 137-140

Author(s):

S. O. Ogunbiyi ◽

M. Coxon ◽

G. Morris-Stiff ◽

R. Ram ◽

M. H. Lewis

Keyword(s):

Carotid Endarterectomy ◽

Optic Neuropathy ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

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Bilateral Anterior Ischaemic Optic Neuropathy Due to Optic Disc Drusen

European Journal of Ophthalmology ◽

10.1177/112067210001000414 ◽

2000 ◽

Vol 10 (4) ◽

pp. 341-343 ◽

Cited By ~ 12

Author(s):

G.G. Kamath ◽

S. Prasad ◽

R.P. Phillips

Keyword(s):

Case Report ◽

Optic Disc ◽

Optic Neuropathy ◽

Optic Disc Drusen ◽

Ischaemic Optic Neuropathy ◽

Underlying Causes ◽

Anterior Ischaemic Optic Neuropathy ◽

Left And Right ◽

Optic Discs

Purpose To report a case of bilateral anterior ischaemic optic neuropathy due to buried optic disc drusen. Methods Case report. Results A 64-year-old man presented with swollen optic discs and features suggestive of anterior ischaemic optic neuropathy (AION) in the left and right eye on two separate occasions ten months apart. Detailed ocular examination at presentation and systemic investigations did not reveal an underlying cause for the AION. At a later follow-up, optic disc drusen were noted in both eyes as partial optic atrophy had set in. This was confirmed by ultrasound B scan and demonstration of autofluorescence. Conclusions In patients presenting with AION uncommon underlying causes must be considered. Routine ultrasound B scan at presentation can easily establish or exclude optic disc drusen as an underlying cause.

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Imageology of internal carotid artery siphon in non-arteritic anterior ischaemic optic neuropathy

International Journal of Ophthalmology ◽

10.18240/ijo.2020.12.15 ◽

2020 ◽

Vol 13 (12) ◽

pp. 1941-1947

Author(s):

Zhi-Yong Fu ◽

Yan-Ling Wang

Keyword(s):

Blood Flow ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Optic Neuropathy ◽

Internal Carotid ◽

Resistance Index ◽

Unaffected Side ◽

Significant Difference ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

AIM: To evaluate whether narrowing of internal carotid artery siphon (ICAS) may increase the risk of developing non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: Totally 30 consecutive patients who had unilateral NAION and 30 gender-matched control subjects were recruited in the present study. The diameter of ICAS of all the participants were measured using head-and-neck computed tomographic angiography (CTA). Color doppler flow imaging (CDI) was used to measure the haemodynamics parameters of ICAS and short posterior ciliary arteries (SPCAs) in all subjects. Comparison of parameters between the NAION patients and controls as well as between the two sides within the patients were performed. The correlation between the diameter of ICAS and NAION was analyzed. RESULTS: A comparison of parameters between the affected side of the NAION patients and the controls, including the diameter of ICAS, the resistance index (RI) of ICAS, the blood flow velocities of SPCAs and RI of SPCAs, showed significantly difference (P<0.01), while there was no significant difference in terms of the mean blood flow velocity (Vm) of ICAS; Similar results were found while comparing all the measurements of the affected and unaffected side of patients (P for RI of SPCAs <0.05). No marked difference was detected in nearly all parameters except for RI of ICAS and SPCAs between the unaffected side of the NAION patients and the controls (P<0.05). The diameter of ICAS were significantly positive correlated with both peak systolic velocity (PSV) of SPCAs and end diastolic velocity (EDV) of SPCAs in patients with NAION (r=0.514, P<0.01 and r=0.418, P<0.05, respectively). CONCLUSION: Narrowing of ICAS may increase the risk of developing NAION.

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Analyses of the relation between internal carotid artery siphon and non-arteritic anterior ischaemic optic neuropathy

10.21203/rs.2.24501/v1 ◽

2020 ◽

Author(s):

zhiyong fu ◽

Hongyang Li ◽

Yanling Wang

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Optic Neuropathy ◽

Ophthalmic Artery ◽

Internal Carotid ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

Abstract Purpose To compare the differences of internal carotid artery siphon(ICAS) and ophthalmic artery (OA) in patients with unilateral non-arteritic anterior ischaemic optic neuropathy (NAION) and age-matched controls.

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