Pathogenese und Therapie der nicht arteriitischen anterioren ischämischen Optikusneuropathie

Oterendorp, Christian van; Lagrèze, Wolf A.; Feltgen, Nicolas

doi:10.1055/a-0972-1625

Cited by 8 publications

(4 citation statements)

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“…DISCUSSION Acute autopsy histopathological analysis of NAION patients has never been performed, and animal studies have promoted the study of the underlying disease process of NAION. Still, the pathogenesis of NAION needs to be clarified due to anatomical differences between species [15] . The most common cause of NAION is hypoperfusion or nonperfusion of the optic disc circulation due to the SPCA, which can be caused by various factors [16][17] .…”

Section: Resultsmentioning

confidence: 99%

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

Ma,

Dai,

Chen

et al. 2024

Int J Ophthalmol

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AIM: To investigate the difference in risk factors between non-arteritic anterior ischaemic optic neuropathy (NAION) and central retinal artery occlusion (CRAO) and develop a predictive diagnostic nomogram. METHODS: The study included 37 patients with monocular NAION, 20 with monocular CRAO, and 24 with hypertension. Gender, age, and systemic diseases were recorded. Blood routine, lipids, hemorheology, carotid and brachial artery doppler ultrasound, and echocardiography were collected. The optic disc area, cup area, and cup-to-disc ratio (C/D) of the unaffected eye in the NAION and CRAO group and the right eye in the hypertension group were measured. RESULTS: The carotid artery intimal medial thickness (C-IMT) of the affected side of the CRAO group was thicker (P=0.039) and its flow-mediated dilation (FMD) was lower (P=0.049) than the NAION group. Compared with hypertension patients, NAION patients had higher whole blood reduced viscosity low-shear (WBRV-L) and erythrocyte aggregation index (EAI; P=0.045, 0.037), and CRAO patients had higher index of rigidity of erythrocyte (IR) and erythrocyte deformation index (EDI; P=0.004, 0.001). The optic cup and the C/D of the NAION group were smaller than the other two groups (P<0.0001). The diagnostic prediction model showed high diagnostic specificity (83.7%) and sensitivity (85.6%), which was highly related to hypertension, the C-IMT of the affected side, FMD, platelet (PLT), EAI, and C/D. CONCLUSION: CRAO patients show thicker C-IMT and worse endothelial function than NAION. NAION and CRAO may be related to abnormal hemorheology. A small cup and small C/D may be involved in NAION. The diagnostic nomogram can be used to preliminarily identify NAION and CRAO.

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Section: Resultsmentioning

confidence: 99%

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

Ma,

Dai,

Chen

et al. 2024

Int J Ophthalmol

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“…Optic disc edema resolves within 4 to 8 weeks, resulting in optic atrophy [37]. NA-AION is a multifactorial illness, with many risk factors that participate in its development but none of them has been yet surely confirmed [38]. It is said that co-occurrence of cardiovascular system hazards with dense nerve structure and blood vessels in optic disc might be the cause [39][40][41].…”

Section: Differentiation Between Leber Hereditary Optic Neuropathy Al...mentioning

confidence: 99%

Optic nerve neuropathies – causative factors, methods of diagnostics, current and future possibilities of treatment

Kobak

Tyczyńska

Forma

et al. 2022

J Educ Health Sport

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Introduction: Optic neuropathies are a broad group of diseases in which the dominant disturbance is damage to the optic nerve, often irreversible. Underlying causes of neuropathy are both genetic and environmental. Despite limited treatment options, much research is currently being done on substances that could improve optic nerve function and alleviate the clinical consequences of optic nerve damage. Purpose: This article describes current findings in both the optic nerve neuropathy pathophysiology and diagnosis of the disorder, as well as treatment options and future perspectives. State of knowledge: The pathogenetic cause of neuropathy is mainly demyelination within the neural sheath, often caused by inflammation. It is characterized by progressive loss of vision. The most common genetic cause of optic neuropathy is mitochondrially inherited Leber hereditary optic neuropathy (LHON) and is characterized by mostly sudden and painless loss of visual acuity. Toxic neuropathies are a group of diseases caused by heavy metals, pharmaceuticals, methanol and carbon monoxide. Nutritional neuropathy is mainly related to vitamin B1, B9 and B12 deficiency, and is a rare example of neuropathy that can be curable at the early stage of the disease. Another group of neuropathies is caused by ischemia and can be divided according to the place of the optic nerve affected – AION (anterior ischemic optic neuropathy) and PION (posterior ischemic optic neuropathy). Conclusions: The therapeutic options in the treatment of optic neuropathy strictly depend on the causative factor. Nutritional deficiencies are treated with appropriate supplementation, so it is vital to truly determine the missing vitamins and elements.

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“…It manifests as a permanent visual field impairment and has unclear pathophysiology (1). It is also the second most common major optic neuropathy after glaucoma, resulting from acute ischemia in the optic nerve (2). Optical coherence tomographyangiography (OCTA) is a new and non-invasive method of vascular mapping that can provide detailed information about the retinal and choroidal vasculature (3,4).…”

Section: Introductionmentioning

confidence: 99%

Detecting changes in the blood flow of the optic disk in patients with nonarteritic anterior ischemic optic neuropathy via optical coherence tomography–angiography

Xiao

Sun

2023

Front. Neurol.

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PurposeThis study aimed to evaluate the changes in the blood flow of the optic disk in patients with nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography–angiography (OCTA) and to investigate the relationship among the changes in the blood flow of the optic disk, visual field defect, peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell complex (mGCC).MethodsThis was a prospective observational case series study. A total of 89 patients (89 eyes) with NAION were included in this study. All patients underwent best corrected visual acuity (BCVA), slit-lamp and direct ophthalmoscopic examinations, color fundus photography, visual field test, and blood flow indicators of the radial peripapillary capillaries (RPC) including whole en face image vessel density (VD), peripapillary VD by OCTA, the peripapillary RNFL, and mGCC by spectral-domain optic coherence tomography (OCT). The changes of blood flow in the optic disk at ≤3, 4–8, 9–12, 13–24, and >24 weeks of the natural course of NAION were measured, and the relationship among the changes in the blood flow of the optic disk, visual field defect, peripapillary RNFL, and mGCC was also analyzed.ResultsThe mean age of 89 patients with NAION was 56.42 ± 6.81 years (ranging from 39 to 79). The initial RPC whole en face image VD was significantly reduced after acute NAION (≤3 weeks) (F = 45.598, P < 0.001) and stabilized from the eighth week onward. Over the course of NAION, the superonasal RPC, superior mGCC, and superotemporal RNFL decreased mostly with time (F = 95.658, 109.787, 263.872, respectively; P < 0.001). Maximal correlations were found between superior mGCC and temporosuperior RPC in the NAION phase (R = 0.683, P < 0.01) and between superonasal RPC and superonasal RNFL (R = 0.740, P < 0.01). The mean defect was correlated with temporosuperior RPC (R = −0.281, P < 0.01) and superior mGCC (R = −0.160, P = 0.012).ConclusionOver the course of NAION, OCTA shows a tendency toward change in the retinal capillary plexus of the optic disk. OCTA is proved to be a practical and useful tool for observing papillary perfusion in NAION.

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Pathogenese und Therapie der nicht arteriitischen anterioren ischämischen Optikusneuropathie

Cited by 8 publications

References 60 publications

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

Optic nerve neuropathies – causative factors, methods of diagnostics, current and future possibilities of treatment

Detecting changes in the blood flow of the optic disk in patients with nonarteritic anterior ischemic optic neuropathy via optical coherence tomography–angiography

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