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Yan Guo, Zara Mehrabian, Steven L Bernstein
Nonarteritic anterior ischemic optic neuropathy (NAION) is a focal ischemic lesion of the optic nerve that affects 1/700 individuals throughout their lifetime. NAION results in optic nerve edema, selective loss of the retinal ganglion cell neurons (RGCs) and atrophy of the optic nerve. A rodent model of NAION that expresses most NAION features and sequelae has been developed, which is applicable to both rats and mice. This model utilizes a focal laser application of 532 nm wavelength to illuminate a photoactive dye, Rose Bengal (RB), to cause capillary damage and leakage at the targeted anterior optic nerve (the laminar region)...
November 20, 2016: Journal of Visualized Experiments: JoVE
Howard D Pomeranz
Phosphodiesterase-5 inhibitors (PDE5I) are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood. Because neuro-ophthalmologists have accepted that there is a potential relationship between ingestion of the PDE5I class of medications and NAION, the neuro-ophthalmologist should inquire about PDE5I use when evaluating a patient with a new diagnosis of NAION, and counsel patients regarding the implication of continued use of PDE5I...
February 2017: Neurologic Clinics
Rod Foroozan
Despite increasing knowledge about the risk factors and clinical findings of nonarteritic anterior ischemic optic neuropathy (NAION), the treatment of this optic neuropathy has remained limited and without clear evidence-based benefit. Historical treatments of NAION are reviewed, beginning with the Ischemic Optic Neuropathy Decompression Trial. More recent treatments are placed within the historical context and illustrate the need for evidence-based therapy for ischemic optic neuropathy.
February 2017: Neurologic Clinics
Paul Richter, Helmut Wilhelm, Tobias Peters, Holger Luedtke, Anne Kurtenbach, Herbert Jaegle, Barbara Wilhelm
PURPOSE: To compare the chromatic pupillary light responses (PLR) in healthy subjects with those from patients with diseases of the outer or inner retina under various stimulus conditions, and to ascertain the parameters required to optimally distinguish between disease and control groups. METHODS: Fifteen patients with retinitis pigmentosa (RP), 19 patients with optic nerve disease (ON), and 16 healthy subjects were enrolled in this prospective study. ON included optic neuritis (NNO) and non-arteritic anterior ischemic optic neuropathy (NAION)...
October 26, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Tae Hee Lee, Hwan Heo, Sang Woo Park
The development of optical coherence tomography (OCT) has changed the clinical management of ophthalmic diseases by furthering the understanding of pathogenesis, as well as improving the monitoring of their progression and assisting in quantifying the response to treatment modalities in ophthalmic diseases. Initially, the two-dimensional configuration of the optic nerve head (ONH) and the thickness of the retinal nerve fiber layer (RNFL) were the main OCT structural parameters used in clinical management of optic nerve diseases...
September 2016: Chonnam Medical Journal
Zsuzsa Balogh, Márta Kasza, Julianna Várdai, Izabella Reznek, Judit Damjanovich, Adrienne Csutak, András Berta, Valéria Nagy
This study aimed to assess the relationship between the rate of nerve fiber loss in non-arteritic anterior ischemic optic neuropathy (NAION) and time delay before therapy. Total 24 patients received the same treatment within or after 2wk (early and late groups). There were significantly lower level of destruction of nerve fibers (P=0.0014) and significantly better visual field sensitivity (P=0.039) in early group. The results indicate that therapy should be started within 2wk. The degree of ischemic damage due to NAION correlates well with retinal nerve fiber layer thickness and the ischemia-induced decrease in visual field sensitivity...
2016: International Journal of Ophthalmology
Dean M Cestari, Eric D Gaier, Peggy Bouzika, Taylor S Blachley, Lindsey B De Lott, Joseph F Rizzo, Janey L Wiggs, Jae H Kang, Louis R Pasquale, Joshua D Stein
OBJECTIVE: Nonarteritic anterior ischemic optic neuropathy (NAION) is a devastating ocular condition causing permanent vision loss. Little is known about risk factors for developing this disease. We assessed demographic, systemic, and ocular factors associated with NAION. DESIGN: Retrospective longitudinal cohort study. PARTICIPANTS: Beneficiaries between 40 and 75 years old without NAION at baseline enrolled in a large U.S. managed care network...
September 19, 2016: Ophthalmology
Masoud Aghsaei Fard, Marjan Afzali, Parisa Abdi, Rebecca Chen, Mehdi Yaseri, Ebrahim Azaripour, Sasan Moghimi
PURPOSE: To compare optic nerve head (ONH) morphology of optic nerve atrophy between eyes with primary open-angle glaucoma (POAG) and eyes with a history of nonarteritic anterior ischemic optic atrophy (NAION) using enhanced depth imaging (EDI) with spectral-domain optical coherence tomography (SD-OCT). METHODS: In this cross-sectional study, 121 eyes of 91 patients consisted of moderate to severe POAG (n = 32 eyes), visual field mean deviation-matched NAION (n = 30 eyes) and their fellow eyes (n = 30 eyes), and healthy controls (n = 29)...
September 1, 2016: Investigative Ophthalmology & Visual Science
Eric D Gaier, Nurhan Torun
PURPOSE OF REVIEW: Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common cause of acute optic nerve injury, and frequently presents to comprehensive ophthalmologists. We review the typical and atypical clinical features and current literature on various treatment modalities for NAION. RECENT FINDINGS: The epidemiology and clinical presentation of this disease can be variable, making a definitive diagnosis difficult in many cases. In addition, the differential diagnoses for this disorder, although comprising much less prevalent entities, are quite broad and can have substantial systemic implications if these alternatives go unrecognized...
November 2016: Current Opinion in Ophthalmology
Lina Nagia, Carrie Huisingh, John Johnstone, Lanning B Kline, Mark Clark, Michael J A Girard, Jean Martial Mari, Christopher A Girkin
PURPOSE: This study examined the peripapillary choroidal thickness (PCT) in nonarteritic ischemic optic neuropathy (NAION) in comparison to contralateral eyes and normal eyes. METHODS: We used enhanced depth imaging spectral-domain optical coherence tomography to image the optic nerve head of 20 NAION, 10 contralateral eyes, and 102 normal eyes. Following compensation, the scans were manually delineated to identify relevant surfaces including Bruch's membrane opening (BMO), Bruch's membrane, and anterior sclera...
September 1, 2016: Investigative Ophthalmology & Visual Science
Prem S Subramanian, Lynn K Gordon, Laura Bonelli, Anthony C Arnold
BACKGROUND: The time of onset of optic disc swelling in non-arteritic anterior ischaemic optic neuropathy (NAION) is not known, and it is commonly assumed to arise simultaneously with vision loss. Our goal is to report the presence and persistence of optic disc swelling without initial vision loss and its subsequent evolution to typical, symptomatic NAION. METHODS: Clinical case series of patients with optic disc swelling and normal visual acuity and visual fields at initial presentation who progressed to have vision loss typical of NAION...
August 26, 2016: British Journal of Ophthalmology
Yueh-Chang Lee, Jen-Hung Wang, Tzu-Lun Huang, Rong-Kung Tsai
PURPOSE: To investigate the incidence and prevalence of nonarteritic anterior ischemic optic neuropathy (NAION), and to extrapolate the risk of cerebrovascular events following NAION. DESIGN: Retrospective cohort study. METHODS: We identified NAION patients first, and then looked for the diagnosis of stroke after the diagnosis of NAION. SETTING: The study group was composed of patients diagnosed with NAION seeking ambulatory care from 2000 to 2011...
October 2016: American Journal of Ophthalmology
Mohammad Pakravan, Nasrin Sanjari, Hamed Esfandiari, Parastou Pakravan, Mehdi Yaseri
BACKGROUND: To evaluate the effect of high-dose intravenous steroids, as well as normobaric oxygen therapy, in the management of recent onset non-arteritic anterior ischemic optic neuropathy (NAION). METHOD: Ninety eyes of 90 patients diagnosed with NAION within 14 days of onset were included in this single masked randomized clinical trial. Thirty patients were randomized into each set as group 1 (control), group 2 (steroids), and group 3 (oxygen). Controls received placebo; group 2 received methylprednisolone 500 mg twice a day for 3 days followed by 2 weeks of oral prednisolone 1 mg/kg/day; group 3 received 100 % normobaric oxygen with mask, at a flow rate of 5 liters per minute for 1 hour twice a day for two weeks...
October 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
J Lenk, C Hermann, E Matthé, L E Pillunat, D Sandner
Background: Optic nerve disease can occur from a variety of different causes, with vascular, inflammatory or toxic pathologies. In such cases, it is hardly possible to clarify the aetiology. These diseases of the optic nerve are usually accompanied by progressive loss of visual field and visual impairment. Patient: We report a case of a 74-year-old woman complaining of loss of visual acuity, visual and blurred vision in the left eye in 2010. We made the diagnosis of non-arteritic ischemic optic neuropathy (NAION)...
August 10, 2016: Klinische Monatsblätter Für Augenheilkunde
Min Kyung Kim, Ungsoo Samuel Kim
PURPOSE: We evaluated fundus and fluorescein angiography (FAG) findings and characteristics that can help distinguish nonarteritic anterior ischemic optic neuropathy (NAION) from optic neuritis (ON). METHODS: Twenty-three NAION patients and 17 ON with disc swelling patients were enrolled in this study. We performed fundus photography and FAG. The disc-swelling pattern, hyperemia grade, presence of splinter hemorrhages, cotton-wool spots, artery/vein ratio and degree of focal telangiectasia were investigated...
August 2016: Korean Journal of Ophthalmology: KJO
Elisabet De Dompablo, J García-Montesinos, F J Muñoz-Negrete, G Rebolleda
PURPOSE: To assess the capability of ganglion cell-inner plexiform layer (GCIPL) thickness analysis by optical coherence tomography (OCT) to detect early neuronal loss in nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: Sixteen patients with unilateral NAION participated in this prospective study. Complete ophthalmologic evaluation including visual acuity, visual field (VF) test, and spectral domain optical coherence tomography (SD-OCT) of peripapillary retinal nerve fiber layer (pRNFL) and GCIPL thickness were performed in the acute phase (within 1 week: 2...
September 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Betul S Uysal, Fatma Yulek, Pinar Nalcacioglu, Ozge Sarac, Mucella A Yorgun, Nurullah Cagil
OBJECTIVE: To investigate corneal biomechanical properties among individuals with unilateral nonarteritic anterior ischemic optic neuropathy (NAION) compared to healthy gender- and age-matched subjects. METHODS: The study subjects were separated into 2 groups: 66 eyes of 33 patients with unilateral NAION (study group) and 33 eyes of 33 healthy individuals (control group). Reichert ocular response analyzer (Reichert Ophthalmic Instruments) was used to assess corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure values...
September 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Mark J Kupersmith, Mona K Garvin, Jui-Kai Wang, Mary Durbin, Randy Kardon
PURPOSE: Optical coherence tomography reveals retinal ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thinning in chronic optic nerve injury. With acute optic nerve injury, as in acute nonarteritic anterior ischemic optic neuropathy (NAION), swelling obscures early demonstration of RNFL thinning, which might be used to evaluate therapies. We hypothesized that measurement of GCL plus inner plexiform layer (IPL) thickness and trajectory of thinning would show it is an earlier and more accurate biomarker of early permanent neuronal injury...
July 1, 2016: Investigative Ophthalmology & Visual Science
Natalie Erlich-Malona, Carlos E Mendoza-Santiesteban, Thomas R Hedges, Nimesh Patel, Caitlin Monaco, Emily Cole
PURPOSE: To determine whether a pattern of altitudinal ganglion cell loss, as detected and measured by optical coherence tomography (OCT), can be used to distinguish non-arteritic ischaemic optic neuropathy (NAION) from optic neuritis (ON) during the acute phase, and whether the rate or severity of ganglion cell loss differs between the two diseases. METHODS: We performed a retrospective, case-control study of 44 patients (50 eyes) with ON or NAION and 44 age-matched controls...
December 2016: Acta Ophthalmologica
Maria E Rodriguez, Christopher K Burris, Heather D Potter
No abstract text is available yet for this article.
July 2016: Ophthalmology
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