The morphology of an infarct in nonarteritic anterior ischemic optic neuropathy

Tesser, Rachel; Niendorf, Eric; Levin, Leonard A.

doi:10.1016/s0161-6420(03)00804-2

Cited by 139 publications

(118 citation statements)

References 24 publications

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“…16 The structure of the optic disc as a relatively inflexible region encompassing the axons of the optic nerve has been implicated in two histopathologic studies. Tesser et al 25 reported that the infarct documented in their case did not follow a specific vascular territory, suggesting a compartment syndrome as a mechanism. Knox et al 26 reviewed the histopathologic features in 193 eyes classified as having optic nerve ischaemia (without clinical correlation) in the Eye Pathology Laboratory of the Wilmer Eye Institute and accessioned from 1951 to 1998.…”

Section: Pathogenesismentioning

confidence: 82%

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Miller

Arnold

2014

Eye

191

139

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Nonarteritic anterior ischaemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Patients typically present with acute, painless, unilateral loss of vision associated with a variable visual field defect, a relative afferent pupillary defect, a swollen, hyperaemic optic disc, and one or more flame-shaped peripapillary retinal haemorrhages. The pathogenesis of this condition is unknown, but it occurs primarily in patients with structurally small optic discs that have little or no cup and a variety of underlying vascular disorders that may or may not be known at the time of visual loss. There is no consistently beneficial medical or surgical treatment for the condition, but there are now animal models that allow testing of various potential therapies. About 40% of patients experience spontaneous improvement in visual acuity. Patients in whom NAION occurs in one eye have a 15-19% risk of developing a similar event in the opposite eye over the subsequent 5 years.

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Section: Pathogenesismentioning

confidence: 82%

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Miller

Arnold

2014

Eye

191

139

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“…It is widely known that an anatomically small optic nerve lacking physiological cup, so-called crowded disc, predispose patients to NAION. [7][8][9][10][11][12] Although most of the previous papers claimed that cupping did not develop in the patients with NAION unlike those with arteritic AION, 9,11,13 this may be due to the underestimation of cupping in small discs with NAION. To overcome this issue, comparisons with disc area-and age-matched controls were made.…”

Section: Hrt Parameters In Optic Neuropathiesmentioning

confidence: 99%

Evaluation of optic nerve head configuration in various types of optic neuropathy with Heidelberg Retina Tomograph

Nagai-Kusuhara

Nakamura

Kanamori

et al. 2007

Eye

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Purpose To test whether Heidelberg Retina Tomograph (HRT) is applicable to assess the optic nerve head (ONH) configuration of the atrophic phase of non-glaucomatous optic neuropathy when a default set of the reference plane is used. Methods Ten eyes with non-arteritic anterior ischaemic optic neuropathy (NAION), 17 eyes with Leber's hereditary optic neuropathy (LHON), 40 eyes with compressive optic neuropathy (CON) owing to chiasmal tumour, and 241 eyes of control individuals were examined with HRT using the default reference plane. The global values of HRT parameters were evaluated among the groups of patients and controls. The sectoral measurements of the eyes with LHON and CON were compared with controls. To eliminate the influence of disc size and age on HRT measurements, eyes with disc area-and age-matched normal controls were used for comparison with eyes with NAION and LHON. Results Cup parameters in eyes with NAION were similar to those in controls. The retinal nerve fibre layer (RNFL) thickness was significantly thinner in eyes with NAION than that of controls. The eyes with LHON had significantly larger cup parameters, smaller rim volume, and thinner mean RNFL thickness than controls. Eyes with CON had significantly larger rim area and smaller cup parameters but similar RNFL thickness compared with controls. Conclusions When the default reference plane is used, HRT can measure the ONH configuration in eyes with NAION and LHON as expected. However, caution must be made to interpret the parameters obtained from the eyes with CON.

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“…1,4,5,6 Non-arteritic anterior ischaemic optic neuropathy has also been associated with blood pressure fluctuation after major surgeries. 1 An ocular risk factor for NAION is a small, "crowded" optic disc with a small cup-to-disc ratio.…”

Section: Discussionmentioning

confidence: 99%

“…1 An ocular risk factor for NAION is a small, "crowded" optic disc with a small cup-to-disc ratio. 1,4,5,6 The optic nerve infarct in NAION has been previously described as a form of compartment syndrome that causes tissue ischaemia. The rigidity of the sclera confines optic disc swelling causing the compartment syndrome, with resultant ischaemia.…”

Section: Discussionmentioning

confidence: 99%

“…The rigidity of the sclera confines optic disc swelling causing the compartment syndrome, with resultant ischaemia. 4 The pathophysiological mechanism of CE-associated NAION is unclear, but as a causative factor, intraocular pressure increase during surgery has been postulated mainly for the immediate type. Theoretically, perfusion pressure reduction of the posterior ciliary artery results in acute ischaemia of the laminar, prelaminar, and retrolaminal optic nerves as a defining event for NAION.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Non-arteritic Anterior Ischaemic Optic Neuropathy after Uneventful Cataract Extraction

Emeriewen¹,

Kadare²,

Tsatsos

et al. 2016

Neuro-Ophthalmology

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We present the case of a 74-year-old Caucasian female who suffered sudden visual loss after routine phacoemulsification cataract surgery. The patient was subsequently diagnosed with nonarteritic anterior ischaemic optic neuropathy. The case is described in detail, and a concise review of the literature is presented together with the authors' view on the subject outlined. This is a very rare complication after cataract surgery even in high-risk patients with associated systemic comorbidities. We suspect that the previous history of obesity, coronary artery disease, and arteriosclerosis contributed to the development of this serious ocular complication. We suggest appropriate measures to reduce the risk of its occurrence. ARTICLE HISTORY

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The morphology of an infarct in nonarteritic anterior ischemic optic neuropathy

Cited by 139 publications

References 24 publications

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Evaluation of optic nerve head configuration in various types of optic neuropathy with Heidelberg Retina Tomograph

Non-arteritic Anterior Ischaemic Optic Neuropathy after Uneventful Cataract Extraction

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