Comparison of Peripapillary Retinal Nerve Fiber Layer Loss and Visual Outcome in Fellow Eyes Following Sequential Bilateral Non-Arteritic Anterior Ischemic Optic Neuropathy

ABSTRACT

Aim: To report on the correlation of structural damage to the axons of the optic nerve and visual outcome following bilateral non-arteritic anterior ischemic optic neuropathy.

Methods: A retrospective review of the medical records of 25 patients with bilateral sequential non-arteritic anterior ischemic optic neuropathy was performed. Outcome measures were peripapillary retinal nerve fiber layer thickness measured with the Stratus optical coherence tomography scanner, visual acuity and visual field loss.

Results: Median peripapillary retinal nerve fiber layer (RNFL) thickness, mean deviation (MD) of visual field, and visual acuity of initially involved NAION eyes (54.00 µm, −17.77 decibels (dB), 0.4, respectively) were comparable to the same parameters measured following development of second NAION event in the other eye (53.70 µm, p = 0.740; −16.83 dB, p = 0.692; 0.4, p = 0.942, respectively). In patients with bilateral NAION, there was a significant correlation of peripapillary RNFL thickness (r = 0.583, p = 0.002) and MD of the visual field (r = 0.457, p = 0.042) for the pairs of affected eyes, whereas a poor correlation was found in visual acuity of these eyes (r = 0.279, p = 0.176). Peripapillary RNFL thickness following NAION was positively correlated with MD of visual field (r = 0.312, p = 0.043) and negatively correlated with logMAR visual acuity (r = −0.365, p = 0.009).

Conclusion: In patients who experience bilateral NAION, the magnitude of RNFL loss is similar in each eye. There is a greater similarity in visual field loss than in visual acuity between the two affected eyes with NAION of the same individual.

• Non-arteritic anterior ischemic optic neuropathy (NAION)
• optical coherence tomography (OCT)
• retinal nerve fiber layer (RNFL)

DECLARATION OF INTEREST

None of the authors has any conflict of interest or financial interest in the data presented in this study. The data presented in study has not been published elsewhere and has not been, and will not be submitted for publication elsewhere. All authors and co-authors have read the final manuscript, have contributed sufficiently for its preparation and are in agreement with its conclusions. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article.