Clinical profile and predictors of visual outcome in nonarteritic anterior ischemic optic neuropathy

• Main Authors: P T Jyothi, S Bindu, Padma B Prabhu
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Kerala Journal of Ophthalmology
• Subjects: Nonarteritic anterior ischemic optic neuropathy; risk factors; visual outcome
• Online Access: http://www.kjophthal.com/article.asp?issn=0976-6677;year=2018;volume=30;issue=3;spage=183;epage=186;aulast=Jyothi

Background: Nonarteritic anterior ischemic optic neuropathy (NAION) is a disorder of the optic nerve head causing acute painless visual loss in the elderly. Several ocular and systemic risk factors predispose to optic nerve head ischemia. Patients usually have a moderate visual loss which tends to stabilize in a few months, but complete recovery may not occur. Aim: This study aimed to study the clinical profile of NAION and to find the predictors of visual outcome in the study group. Materials and Methods: This prospective case series study included 25 patients with unilateral acute visual loss and clinical features suggestive of NAION. Detailed history and investigations were done to detect the risk factors implicated for the disease Patients were followed up for 6 months. Initial and final vision were analysed to assess the visual outcome. Statistical analysis was performed using SPSS. Results: Mean age was 58.08 ± 8.118 years. There was no gender predilection. The most common type of disc edema was diffuse hyperemic, and the most common field defect was inferior altitudinal. Systemic comorbid conditions such as dyslipidemia, smoking, hypotension, diabetes, and hypertension had higher odds of developing NAION even though not statistically significant. Correlation between initial vision and visual acuity at 6 months was statistically significant and spontaneous improvement in vision was seen in 16% of patients. Conclusion: Pallid disc edema and poor initial visual acuity were predictors of poor visual outcome. Female gender, hyperemic disc edema, and superior field defect had a favorable outcome. Associated comorbidities increased the risk of visual loss.