Hypothesis

Levin, Leonard A.; Danesh‐Meyer, Helen V.

doi:10.1001/archopht.126.11.1582

Cited by 83 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neither lipohyalinosis, occlusion, nor inflammation of the vessels was identified; however, the infarctions identified were predominantly in the retrolaminar portion of the optic nerve head, suggesting less involvement of the choroidal blood supply that primarily supplies the laminar and prelaminar layers. 57 Levin and Danesh-Meyer recently proposed that NAION may be primarily a venous disease; 65 however, this theory remains speculative. A recent study utilizing optical coherence tomography (OCT) demonstrated that 8 of 76 patients examined within 4 weeks of visual loss had subfoveal fluid, likely responsible for some of the reversible visual loss.…”

Section: Iii-pathogenesismentioning

confidence: 99%

Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy

Atkins

Bruce

Newman

et al. 2010

Survey of Ophthalmology

155

View full text Add to dashboard Cite

Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common clinical presentation of acute ischemic damage to the optic nerve. Most treatments proposed for NAION are empirical and include a wide range of agents presumed to act on thrombosis, on the blood vessels, or on the disc edema itself. Others are presumed to have a neuroprotective effect. Although there have been multiple therapies attempted, most have not been adequately studied, and animal models of NAION have only recently emerged. The Ischemic Optic Neuropathy Decompression Trial (IONDT), the only class I large multicenter prospective treatment trial for NAION, found no benefit from surgical intervention. One recent large, nonrandomized controlled study suggested that oral steroids might be helpful for acute NAION. Others recently proposed interventions are intravitreal injections of steroids or anti-vascular endothelial growth factor (anti-VEGF) agents. There are no class I studies showing benefit from either medical or surgical treatments. Most of the literature on the treatment of NAION consists of retrospective or prospective case series and anecdotal case reports. Similarly, therapies aimed at secondary prevention of fellow eye involvement in NAION remain of unproven benefit.

show abstract

Section: Iii-pathogenesismentioning

confidence: 99%

Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy

Atkins

Bruce

Newman

et al. 2010

Survey of Ophthalmology

155

View full text Add to dashboard Cite

show abstract

“…Though the disorder is believed to be secondary to “ischemia”, the exact site of vascular disruption and the mechanism of injury remain unknown. There is debate as to whether the process is primarily the result of arterial or venous occlusion, 5 with some researchers even calling the vascular basis into question. 6 There is good evidence, however, that patients who have a small cup-disc ratio are at higher risk for developing NAION, perhaps because this small ratio causes a “disc at risk” for an “ischemic event”, with subsequent development of a compartment syndrome secondary to edema of the optic nerve head (ONH).…”

Section: Introductionmentioning

confidence: 99%

An Experimental Animal Model of Photodynamic Optic Nerve Head Injury (PONHI)

Mantopoulos

Bouzika

Tsakris

et al. 2016

Current Eye Research

View full text Add to dashboard Cite

Purpose Anterior ischemic optic neuropathy (AION) is the most common cause of non-glaucomatous optic nerve head (ONH) injury among older adults. AION results from a sudden ischemic insult to the proximal portion of the optic nerve, typically leading to visual impairment. Here, we present an experimental model of photodynamically induced ONH injury that can be used to study neuroprotective modalities. Methods Intraperitoneal injection of mesoporphyrin IX was followed by photodynamic treatment of the ONH in one eye of Brown-Norway rats; the fellow eye received the reverse sequence as a sham control. Fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), and visual evoked potential (VEP) recordings were performed at different time points following laser treatment. Immunohistochemistry was used to monitor apoptotic cell death (TUNEL) and macrophage infiltration (CD68). Cytokine levels were evaluated using enzyme-linked immunosorbent assay (ELISA). Results FA showed early hyperfluorescence and late leakage of the ONH, while SD-OCT revealed optic nerve edema. No leakage or other abnormalities were detected in control eyes. VEPs were significantly reduced in amplitude and showed prolonged responses compared to sham eyes. The number of apoptotic retinal ganglion cells was elevated one day after laser treatment (13.77 ± 4.49, p < 0.01) and peaked on day 7 (57.22 ± 11.34, p < 0.01). ONH macrophage infiltration also peaked on day 7 (101.8 ± 9.8, p < 0.05). ELISAs performed showed upregulation of macrophage chemoattractant protein-1 and macrophage inflammatory protein-2 on days 3 and 1, respectively. Conclusions Photodynamic treatment of the ONH after administration of mesoporphyrin IX leads to macroscopic, histologic, and physiologic evidence of ONH injury. Given the long half-life of mesoporphyrin IX and the ease of intraperitoneal injections, this new model of photodynamically induced ONH injury may be a useful tool for studying optic nerve injury and possible neuroprotective treatments.

show abstract

“…Estrogen improves vascular function and decreases atherosclerosis; however, female sex had decreased odds of ION in our study even when controlling for vascular disease and carotid artery stenosis in the multivariable regression leaving the mechanism for this decrease unclear. 38,39 The reason why ION risk in this study differed between uncomplicated diabetes mellitus type 2 and diabetic retinopathy is not known and will require further study.…”

Section: Discussionmentioning

confidence: 92%

Ischemic Optic Neuropathy in Cardiac Surgery

et al. 2017

View full text Add to dashboard Cite

Background Ischemic optic neuropathy is the most common form of perioperative visual loss, with highest incidence in cardiac and spinal fusion surgery. To date, potential risk factors have been identified in cardiac surgery by only small, single-institution studies. To determine the preoperative risk factors for ischemic optic neuropathy, the authors used the National Inpatient Sample, a database of inpatient discharges for nonfederal hospitals in the United States. Methods Adults aged 18 yr or older admitted for coronary artery bypass grafting, heart valve repair or replacement surgery, or left ventricular assist device insertion in National Inpatient Sample from 1998 to 2013 were included. Risk of ischemic optic neuropathy was evaluated by multivariable logistic regression. Results A total of 5,559,395 discharges met inclusion criteria with 794 (0.014%) cases of ischemic optic neuropathy. The average yearly incidence was 1.43 of 10,000 cardiac procedures, with no change during the study period (P = 0.57). Conditions increasing risk were carotid artery stenosis (odds ratio, 2.70), stroke (odds ratio, 3.43), diabetic retinopathy (odds ratio, 3.83), hypertensive retinopathy (odds ratio, 30.09), macular degeneration (odds ratio, 4.50), glaucoma (odds ratio, 2.68), and cataract (odds ratio, 5.62). Female sex (odds ratio, 0.59) and uncomplicated diabetes mellitus type 2 (odds ratio, 0.51) decreased risk. Conclusions The incidence of ischemic optic neuropathy in cardiac surgery did not change during the study period. Development of ischemic optic neuropathy after cardiac surgery is associated with carotid artery stenosis, stroke, and degenerative eye conditions.

show abstract

Hypothesis

Cited by 83 publications

References 27 publications

Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy

Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy

An Experimental Animal Model of Photodynamic Optic Nerve Head Injury (PONHI)

Ischemic Optic Neuropathy in Cardiac Surgery

Contact Info

Product

Resources

About