Analysis Of The Related Factors Of Nonarteritic Anterior Ischemic Optic Neuropathy

Objective To explore the clinical characteristics,risk factors and efficacy of treatment in patients with non-arteritic anterior ischemic optic neuropathy(NAION).Methods The retrospective cases analysis were used for this study.From April2011 to November 2016,sixty-six cases(74 eyes)of NAION patients in the Forth Central Hospital of Tianjin City were used as the research objects.The clinical characteristics,risk factors and the fundus fluorescein angiography(FFA)features and optical coherence tomography(OCT)were analyzed retrospectively.The systemic corticosteroids,at the same time given systemic and local comprehensive therapies,such as glucocorticoid hormone,vasodilator and nerve nutritional agent.The results of corrected visual acuity or visual fields were compared before and after the treatment.Results The male and female ratio of 66 cases of patients was 1.6:1.The average age was 58.6±10.4 years old.All the patients had the visual acuity impairment and visual defect,the quadrant or underpart defect connected with the physiological blind spot which was not involved the central point of regard was common in 71 eyes(36 eyes,50.7%).The fundus changes were swallowing of optic disc in 66 eyes(89.2%).The early phase of FFA examination showed delayed filling and hyperfluorescein at late phase in 45 eyes(60.8%).Among them,46(69.7%)patients were hypertension,26(39.4%)patients with diabetes,37(56%)patients with hyperlipidemia,and 19 patients with a history of smoking,the lower initial vision(<0.3)and the improvement rates of the visual acuity were not directly related to hypertension and diabetes.After the intensive treatments,the visual acuity of the patients were improvement in 38 eyes,the improvement rates was 51.4%;the visual fields were improvement in 34 eyes,the improvement rates was 47.9%.The early phase of FFA examination showed the filling time was shorter than before in 19 eyes,and the ischemic range reduced in 31 eyes.Conclusions The pathogenesis of NAION was caused by multi-factors and usually associated with many systemic and local diseases.Systemic hypertension,diabetes mellitus,hyperlipidemia or arteriosclerosis,no/little optic cup,significanthigh intraocular pressure and smoking,were the main risk factors.We should examine carefully and give a specific diagnosis in clinic.After the active treatments,the visual acuity and visual fields were often improved.