Objective To observe the relationship between shallow optic cup，small disc and occurrence in patients with nonarteritic anterior ischemic optic neuropathy (NAION).Methods Ninetysix patients（96 diseased eyes）who accorded with the diagnosis criteria for NAION，with duration ge; three months and optic disc edema in paracmasis were selected. The fellow eyes of 96 NAION patients and 80 normal eyes were selected in our study. The horizontal and vertical disc and cup diameters，optic cup depth, and peripapillary retinal nerve fiber layer (RNFL) thickness were measured by quot;crossquot; and quot;ringquot; scan of optical coherence tomography (OCT，Humphrey 2000，German Carl Zeiss Company) inspection system. The cup depth were classified four grades by cup shape according to OCT images：GradeⅠ，bottom of optic cup above the anterior plane of peripapillary neuroepithelial layer（PNL）；GradeⅡ，bottom of optic cup above the plane of PNL；Grade Ⅲ，bottom of optic cup between the plane of PNL and choroidal pigment epithelium；Grade Ⅳ，bottom of optic cup under the plane of choroidal pigment epithelium connection. The grades of optic cup and value in three groups were statistically analyzed. The follow up ranged from six months to three years.Results The disc diameter in horizontal scanning of diseased eyes，fellow eyes and normal eyes were (1.29plusmn;0.19), (1.32plusmn;0.17), (1.40plusmn;0.15) mm，and diameters in vertical scanning were (1.52plusmn;0.14), (1.49plusmn;0.17), (1.60plusmn;0.22) mm, respectively. Compared the diseased eyes and fellow eyes with normal eyes，the difference were statistically significant in horizontal scanning (t=4.291,3.315; P＜0.05) and in vertical scanning (t=2.812, 3.654; P＜0.05). Compared the diseased eyes with fellow eyes，the difference of average diameter were not statistically significant in horizontal and vertical scanning (t=1.153,1.335; P＞0.05). Of the diseased eyes，GradeⅠoptic cup in 36 eyes（37.50），Grade Ⅱ-Ⅲoptic cup in 52 eyes（54.17%），Grade Ⅳoptic cup in eight eyes（8.33%），and GradeⅠ-Ⅲ optic cup in 88 eyes（91.67%）were found. Of the fellow eyes，GradeⅠoptic cup in 18 eyes（18.75%），Grade Ⅱ-Ⅲoptic cup in 69 eyes（71.88%），Grade Ⅳoptic cup in nine eyes（9.34%），and GradeⅠ-Ⅲ optic cup in 87 eyes（9066%）were found. Compared the average RNFL thickness of diseased eyes with the fellow eyes and normal eyes，the differences were statistically significant in temporal, upper, nasal, lower quadrant(t=12.862，10.147，15.046，8.180，12.859，9.562，12.174，8.632；P＜0.001). Compared the average RNFL thickness of the fellow eyes and normal eyes，the differences were not statistically significant in all quadrants（t=1.040，1.576，1.062，1.192；P＞0.05）. During the followup，eight eyes with recurrence which optic cup were GradeⅠand Ⅱin diseased eyes；44 eyes（45.8%）occurred NAION. Correlation analysis showed that there was negative correlation between incidence of fellow eye and optic cup depth(t=-0.757, P=0.000). Conclusion Optic cup and disk in NAION patients are smaller than that in the normal，the anatomical characteristics of shallow cup and small disc was one of the NAION pathogenesis.
Objectives To evaluate the risk factors of nonarteritic a nterior ischemic optic neuropathy（NAION）in a population of China and to provide theory basis for clinical decision. Methods Demographic features and clinical data of NAION were recorded. Cerebral infarction (CI) patients were also collected as control group. Systemic evaluations including whole blood chemical test, brain MRI, carotid artery ultrasound and fundus photography were perfor med in NAION and CI patients. The fundus photography and cup/disk ratio were als o acquired in a healthy controlgroup with matched age and gender. Statistical a nalysis was done by SPSS11.5 software. Results Thirtyeight N AION patients and 40 CI patients with intact data were included. Fundus photography and cup/disk ratio were acquired in 41 healthy individuals. No statistically significant difference regard to incidences of diabetes, male gender and lipid metabolic abnormalities was found between NAION and CI patients (Pgt;0.05). H ypertension, clinical and subclinical cerebral vascular disease and carotid ar tery stenosis were statistically more commonin CI patients than in NAION patien ts (Plt;0.01, 0.05). Cup/disk ratio was statistically significant smaller in NAION than in CI patients while no statistical difference (Pgt;0.05) was fo und between the CI group and healthy individuals. Conclusions NAION shared similar risk factors with cerebral infarction, but exposure of these risk factors was different between NAION and cerebral infarction. Hypertension , cerebral vascular disease and carotid artery stenosis were more common in cere bral infarction while diabetes, male gender and lipid metabolic abnormalities were similar. Small cup/disk ratio was an independent and the most important risk factor for NAION. (Chin J Ocul Fundus Dis,2008,24:86-89)
ObjectiveTo observe the clinical profile and risk factors of non-arteritic anterior ischemic optic neuropathy (NAION). MethodsProspective study was conducted to consecutively recruit 73 patients with NAION from October 2013 through September 2015. A detailed history of previous systemic diseases, smoking and drinking was collected, and a comprehensive ophthalmic evaluation was performed. The prevalence of associated risk factors in NAION patients were compared to the 146 age-and gender-matched normal subjects, and assessed in logistic regression model. ResultsOf the 73 patients, 65.75% were males, 34.25% were females. The mean age was (55.18±9.89) years. 21.92% were bilateral and 78.08% were unilateral. Arcuate visual field defect (31.58%) was the most prevalent defect detected in unilateral NAION, and there were 8.93% fellow eyes with abnormal optic disc formation in incipient stage. Concentric visual field contraction (40.63%) was the most common in bilateral NAION. Obesity (OR=8.09, 95% CI: 2.94-22.23, P < 0.001) and diabetes (OR=4.72, 95% CI: 1.57-14.25, P=0.006) were significantly associated with NAION. While smoking was marginally associated with NAION (OR=2.76, 95% CI: 1.02-7.53, P=0.047). ConclusionsThe gender predisposition should be reconsidered in NAION. We should pay attention to the fellow eye in case of the incipient NAION patients. Diabetes and obesity are associated with NAION.
Non-arteritic anterior ischemic optic neuropathy (NAION) is one of the most common acute optic neuropathy in adult characterized with impaired visual acuity and visual fields. The pathogenesis of NAION mostly result from the interactions between the systemic risk factors (such as diabetes mellitus, night hypotension, hereditary) and the local ocular risk factors (such as small optic disc and vitreo-papillary traction). A fully promoted diagnosis and treatment of NAION are based on the higher levels of clinical evidence, as well as the comprehensive assessment of relationship between the systemic and ocular risk factors in the pathogenesis of NAION. Secondary optic neuropathy of NAION and the early diagnosis with effective treatment of the fellow eye would be highly emphasized.
ObjectiveTo analyze retrospectively the risk factors of nonarteritic anterior ischemic optic neuropathy (NAION). MethodsThe complete clinical data of 116 patients (134 eyes) were collected. All patients were asked in detail about the disease history and symptoms and were examined for the visual acuity, intraocular pressure, fundus, visual field and fundus fluorescein angiography (FFA), blood pressure, blood glucose, blood fat and head MRI or CT. Suspicious cases and patients with incomplete clinical data were excluded. The relationship between NAION and age, visual field, FFA, systemic and ocular factors, onset seasons were retrospectively analyzed. Results80 patients (68.97%) were 55 to 70 years old. 97 patients (83.7%) had systemic diseases, including 38 patients (39.2) with diabetes mellitus, 32 patients (32.9%) with hypertension (8 patients had low blood pressure at night), 28 patients (28.9%) with hyperlipidemia, 16 patients (16.5%) with cerebrovascular diseases (mainly lacunar cerebral infarction), 6 patients (6.2%) with coronary heart disease. There were 8 patients with ocular factors, including 3 patients (2.6%) with cataract surgery history, 5 patients (4.2%) with small optic discs. The difference of percentage of with or without diabetes mellitus and hypertension was significant (χ2=362, 259; P < 0.05). There were 27.6% patients with disease onset at March to April, 24.1% patients with disease onset at September to October, much higher than other months (χ2=580, P < 0.05). Visual field test results showed that 49 eyes (36.5%) had inferior visual field defect, 12 eyes (9.0%) had superior visual field defect. FFA showed that in the early stage 103 eyes (76.9%) had optic weak fluorescence, 13 eyes (9.7%) had strong fluorescence; in the late stage, 110 eyes (82.1%) had strong fluorescence, 8 eyes (6.0%) had weak fluorescence. ConclusionsDiabetes mellitus, hypertension may be the system risk factors of NAION. The seasonal variation from spring to summer and from autumn to winter may also be another risk factor for the onset of NAION.
ObjectiveTo investigate the association of high density lipoprotein cholesterol (HDL-C) and cholesterol ester transfer protein (CETP) TaqIB mutation with non-arteritic anterior ischemic optic neuropathy (NA-AION) in the Shaanxi Han ethnic population. MethodsThe study cohort consisted of 45 individuals that had been diagnosed with NA-AION and 45 healthy controls (matched for age, gender). None of the cases or controls had a history of diabetes, serious cardio-cerebral vascular diseases, liver and kidney dysfunction that might influence plasma lipid levels. Plasma HDL-C was detected by enzyme-linked immunosorbent one-step, through the Toshiba TBA-40FR automatic biochemical analyzer. CETP TaqIB gene polymorphism was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques for analysis. B2B2 genotype was only a fluorescence band with 535 bp; B1B1 genotype was 2 fluorescence bands with 361, 174 bp; B1B2 genotype was 3 fluorescence bands with 535, 361, 174 bp. The relative risk of genotype, HDL-C and disease occurrence was analyzed by logistics regression analysis. ResultsThere have no significant difference between NA-AION patients and controls about plasma total cholesterol level and triglyceride level (t=1.907, 1.877; P > 0.05). The plasma HDL-C levels were significantly lower in NA-AION patients than in controls (t=2.367, P=0.022). Compared with controls, the prevalence of B1B1 genotype and B1 allele was higher (χ2=17.289, P=0.001), the prevalence of B2 allele (χ2=15.648, P=0.000) was lower in NA-AION patients. The lower concentration of HDL-C was risk factor of NA-AION (odds ratio=6.143, 95% confidence interval 1.262-29.895, χ2=27.676;P=0.013). The proportion of B1B1 genotype was significantly higher in NA-AION patients than in controls (odds ratio=2.24, 95% confidence interval 2.427-36.323, χ2=10.526; P=0.001). ConclusionsThe low plasma HDL-C is independent risk factor for NA-AION and is associated with the development of NA-AION in the Shaanxi Han ethnic population. CETP TaqIB mutation is associated with low plasma HDL-C in NA-AION in the Shaanxi Han ethnic population.