Individual Prognosis and Clinical Course of Nonarteritic Anterior Ischemic Optic Neuropathy.

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Felix Tonagel, Helmut Wilhelm, Michael Birk, Carina Kelbsch
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引用次数: 0

Abstract

Background: To investigate the clinical course of nonarteritic anterior ischemic optic neuropathy (NAION), in particular the presence of individual prognostic markers and the occurrence of a 2-stage progression of the disease.

Methods: In this retrospective study, 116 eyes of 100 patients with NAION were included. The selection was made in reverse consecutive order, starting with patients who presented to the University Eye Clinic, Tuebingen, Germany in December 2022.

Results: Sixty-three percent of the patients were men, median age was 61.5 years. Of all patients, obstructive sleep apnea was found in 73.5%, arterial hypertension (aHT) in 69.9%. Second eye involvement was observed in 15% of the patients. The median follow-up was 56 days. Median visual acuity (VA, decimal) of all eyes examined was 0.63 in the first test and 0.5 in the final test, a clinically relevant VA decrease of at least 2 lines occurred in 27.5%. A worsening of visual field (VF) defects happened in 42.5%. Worst VA and VF prognosis were in relation to an initial circular swelling of the optic disc. Best final VA occurred with initial superior swelling, best final VF findings with initial inferior swelling. Considerable increase in optic disc swelling during the observation period occurred in 16.4% of the eyes (n = 19) at a median of 24 days after initial presentation.

Conclusions: The configuration of the initial optic disc swelling is a prognostic marker, with circular swelling having the worst prognosis for VA and VF. In total, 16.4% of the affected eyes, particularly in men with initially good visual acuity, showed a 2-stage progression of optic disc swelling with poor visual prognosis. Second eye involvement occurred in 15% of our cohort.

非动脉性前缺血性视神经病变的个体预后和临床病程。
背景:研究非动脉性前缺血性视神经病变(NAION)的临床病程,特别是个体预后标志物的存在和该疾病2期进展的发生。方法:回顾性分析100例NAION患者116只眼。从2022年12月在德国图宾根大学眼科诊所就诊的患者开始,按照相反的顺序进行选择。结果:63%的患者为男性,中位年龄61.5岁。阻塞性睡眠呼吸暂停占73.5%,动脉性高血压占69.9%。15%的患者第二只眼受累。中位随访时间为56天。所有眼睛的中位视力(VA,十进制)在第一次测试中为0.63,在最后一次测试中为0.5,临床上相关的VA至少下降了2线,占27.5%。42.5%发生视野缺损加重。最差的VA和VF预后与视盘的初始圆形肿胀有关。最佳的最终VF表现为最初的上肿胀,最佳的最终VF表现为最初的下肿胀。在观察期间,16.4%的眼睛(n = 19)在初次出现后的中位24天内视盘肿胀明显增加。结论:视盘初始肿胀的形态是一种预后指标,圆形肿胀在室性视裂和室性视裂中预后最差。总的来说,16.4%的受影响的眼睛,特别是最初视力良好的男性,表现为视盘肿胀的2期进展,视力预后较差。第二眼受累发生率为15%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Neuro-Ophthalmology
Journal of Neuro-Ophthalmology 医学-临床神经学
CiteScore
2.80
自引率
13.80%
发文量
593
审稿时长
6-12 weeks
期刊介绍: The Journal of Neuro-Ophthalmology (JNO) is the official journal of the North American Neuro-Ophthalmology Society (NANOS). It is a quarterly, peer-reviewed journal that publishes original and commissioned articles related to neuro-ophthalmology.
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