Clinical characteristics and prognosis of bilateral nonarteritic ischemic optic neuropathy patients in 61 cases

Abstract

AIM: To evaluate the clinical characteristics of patients with bilateral nonarteritic ischemic optic neuropathy(NAION)and the prognosis of NAION's impact factors.METHODS: NAION patients with both eyes onset from 2006 were included in this study, their clinical characteristics, treatment methods, the demographic index, medical history, visual acuity, visual field and other clinical data of NAION, including the impact factors of the prognosis, were obtained statistically. RESULTS: A total of 61 patients(122 eyes)have been diagnosed with NAION bilaterally, including 39 males and 22 females, with an average age of 58.0±11.0 years old, and the duration of the first onset was 12.5mo(IQR 4.75-26.5). The median of the best log MAR corrected visual acuity of the 122 eyes at initial visit were 0.7 logMAR(IQR 0.2-1.3), optic disc edema was seen in 38 eyes while optic disc saw in 76 eyes were pale or white. The most common types of visual field defects were inferior altitudinal visual field defect(38 eyes), supero-nasal defect(21 eyes), infero-nasal defect(16 eyes), superior altitudinal visual field defect(13 eyes), and tubular visual field defect(12 eyes). Among all the patients, there were 31 accompanied with hypertension, hyperlipidemia, diabetes, or a history of other cardiovascular and cerebrovascular diseases. After an median of 12mo(IQR 6-23.5)of follow-up observation, the visual acuity has been increased from 0.7 logMAR(IQR 0.2-1.3)to 0.4 logMAR(IQR 0.175-1.1), in which 45 eyes(36.9%)increased 2 lines or more. Best corrected visual acuity(BCVA)had no significant differences(Z=-0.521, -1.600, P>0.05)between the male and female patients at initial visit and during follow-up. BCVA of patients accompanied with cardiovascular or cerebrovascular disease had no significant differences(Z=-1.103, P>0.05)from those without cardiovascular or cerebrovascular disease before the treatment, while there were significant differences(Z=-2.090,PP=0.003, 0.019)than that at last visit, while BCVA of earlier onset cases improved more than later onset cases(median with 0.2 and 0.1 logMAR respectively, P=0.195)though there was no significant differences.CONCLUSION: After summarizing the demographic index, incidence, medical history, visual acuity, and visual field characteristics of the bilateral NAION patients, we found that patients who were accompanied with cardiovascular or cerebrovascular disease and the later onset eyes might had a poor prognosis than the others, though there were further evidence needed to support this finding.

Keywords

• clinical characteristics; prognosis; nonarteritic ischemic optic neuropathy