Ischemic Optic Neuropathy: Incidence, Clinical Profile and Long-Term Prognosis in Qatar

Abstract

Background: Ischemic optic neuropathy (ION) is the most common optic neuropathy in patients over the age of 50 years. It has variable clinical features, prognosis and associated risk factors. As far as we know there are no published data about ION from other Arabic countries. Objective: We describe the clinical presentation, associated risk factors and the prognosis in patients presenting to our hospital and compare our findings with USA studies. Methods: In a hospital-based prospective study, consecutive patients with a diagnosis of ION seen between January 2001 and December 2004 were included. Detailed neuro-ophthalmic evaluation, laboratory and neuroradiological investigations were performed in all patients. The patients were followed up at the clinic for mean period of 18 months. Results: Twenty-six patients, 21 males and 5 females (male to female ratio 4.2:1) were enrolled. Mean age was 50.3years. The incidence was calculated as 1/100,000/year. Anterior ION was the commonest type (88%). Vascular risk factors were common; e. g. diabetes mellitus (DM) (58%), hypertension (HTN) (42%), hypercholesterolemia (10%). Prevalence of disc-at-risk (small or absent physiological cup) was (16%) and of temporal arteritis was uncommon (4%). Brain MRI showed ischemic vascular changes in (29%). Conclusion: The incidence of ION in Qatar is much less and showed male predominance when compared with data from USA. Anterior non-arteritic ION is the commonest type. Vascular risk factors were more common while prevalence of disc at-risk and temporal arteritis was less compared to USA studies while DM was higher. Therefore, controlling risk factors may reduce the incidence of ION.