TY - JOUR
T1 - Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy
T2 - Demographics, Risk Factors, and Visual Outcomes
AU - Chung, Jennifer E.
AU - Singaravelu, Janani
AU - Wilson, Bradley S.
AU - Baykal, Annah P.
AU - Lee, Michael S.
AU - McClelland, Collin M.
AU - Chen, John J.
AU - Bhatti, M. Tariq
AU - Melson, Andrew T.
AU - Van Stavern, Gregory P.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background:Although nonarteritic anterior ischemic optic neuropathy is a well-known cause of vision loss, it typically presents unilaterally. Simultaneous, bilateral nonarteritic anterior ischemic optic neuropathy (sNAION) is rare and poorly studied in comparison. This study seeks to characterize the clinical features and risk factors of patients with sNAION compared with unilateral NAION (uNAION).Methods:In this retrospective case-control study, we reviewed 76 eyes (38 patients) with sNAION and 38 eyes (38 patients) with uNAION (controls) from 4 academic institutions examined between 2009 and 2020. Demographic information, medical history, medication use, symptom course, paraclinical evaluation, and visual outcomes were collected for all patients.Results:No significant differences were observed in demographics, comorbidities and their treatments, and medication usage between sNAION and uNAION patients. sNAION patients were more likely to undergo an investigative work-up with erythrocyte sedimentation rate measurement (P = 0.0061), temporal artery biopsy (P = 0.013), lumbar puncture (P = 0.013), and MRI (P < 0.0001). There were no significant differences between the 2 groups for visual acuity, mean visual field deviation, peripapillary retinal nerve fiber layer thickness, or ganglion cell-inner plexiform layer thickness at presentation, nor at final visit for those with ≥3 months of follow-up. The sNAION eyes with ≥3 months of follow-up had a smaller cup-to-disc ratio (CDR) at final visit (P = 0.033). Ten patients presented with incipient NAION, of which 9 suffered vision loss by final visit.Conclusion:Aside from CDR differences, the risk factor profile and visual outcomes of sNAION patients seem similar to those of uNAION patients, suggesting similar pathophysiology.
AB - Background:Although nonarteritic anterior ischemic optic neuropathy is a well-known cause of vision loss, it typically presents unilaterally. Simultaneous, bilateral nonarteritic anterior ischemic optic neuropathy (sNAION) is rare and poorly studied in comparison. This study seeks to characterize the clinical features and risk factors of patients with sNAION compared with unilateral NAION (uNAION).Methods:In this retrospective case-control study, we reviewed 76 eyes (38 patients) with sNAION and 38 eyes (38 patients) with uNAION (controls) from 4 academic institutions examined between 2009 and 2020. Demographic information, medical history, medication use, symptom course, paraclinical evaluation, and visual outcomes were collected for all patients.Results:No significant differences were observed in demographics, comorbidities and their treatments, and medication usage between sNAION and uNAION patients. sNAION patients were more likely to undergo an investigative work-up with erythrocyte sedimentation rate measurement (P = 0.0061), temporal artery biopsy (P = 0.013), lumbar puncture (P = 0.013), and MRI (P < 0.0001). There were no significant differences between the 2 groups for visual acuity, mean visual field deviation, peripapillary retinal nerve fiber layer thickness, or ganglion cell-inner plexiform layer thickness at presentation, nor at final visit for those with ≥3 months of follow-up. The sNAION eyes with ≥3 months of follow-up had a smaller cup-to-disc ratio (CDR) at final visit (P = 0.033). Ten patients presented with incipient NAION, of which 9 suffered vision loss by final visit.Conclusion:Aside from CDR differences, the risk factor profile and visual outcomes of sNAION patients seem similar to those of uNAION patients, suggesting similar pathophysiology.
UR - http://www.scopus.com/inward/record.url?scp=85148114167&partnerID=8YFLogxK
U2 - 10.1097/WNO.0000000000001642
DO - 10.1097/WNO.0000000000001642
M3 - Article
C2 - 36166810
AN - SCOPUS:85148114167
SN - 1070-8022
VL - 43
SP - 86
EP - 90
JO - Journal of Neuro-Ophthalmology
JF - Journal of Neuro-Ophthalmology
IS - 1
ER -