ABSTRACT
Non-arteritic anterior ischemic optic neuropathy (NAION) is a disease characterized by acute, painless visual acuity loss and visual field impairment, and there is still lack of unified and effective treatment.As new therapeutic strategies, neuroprotection and nerve regeneration have aroused wide public concern, which aim to prevent degeneration and death of neurons or establish a new neural circuit through inhibiting apoptosis pathway and inflammation, promoting axon growth and applying stem cells.Plenty of studies have applied the strategies to NAION patients or NAION animal models, which achieved certain success, but the limitations exist at the same time.For the sake of exploring practical therapies of NAION, researches on the neuroprotection and nerve regeneration strategies of NAION in recent years were reviewed in this article.
ABSTRACT
Objective To observe the effect of lowering intraocular pressure(IOP) treatment on ocular hemodynamics in patients with nonarteritic anterior ischemic optic neuropathy (NAION).Methods A total of 68 patients with NAION (68 eyes) were enrolled in this study.The patients were randomly divided into treatment group (38 eyes of 38 patients) and control group (30 eyes of 30 patients).All the patients were received methylprednisolone pulse therapy (200 mg,three days),vasodilator therapy with intravenous infusion of Xueshuantong solution (300 mg),optic nerve nutritional therapy with mouse nerve growth factor (30 μg) and acupoint injection in temporal with compound anisodine (2 ml).The total course was 10 days.The patients of treatment group received IOP lowering treatment to reduce the IOP to ≥ 8 mm Hg (1 mm Hg=0.133 kPa) or in a 30％ reduction.The patients of control group received no IOP lowering treatment.The peak systolic velocity (PSV),pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and after treatment were comparatively analyzed by color doppler flow imaging.Results The differences of PSV (t=1.023,1.145,0.569),PI (t=0.679,0.956,1.634) and RI (t=0.816,1.657,0.998) of OA,CRA and PCA before treatment in treatment group and control group were not statistically significant (P＞ 0.05).Compared with before treatment,PSV (t=3.150,7.650,3.520) and PI (t=2.420,5.430,7.650) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=5.320,9.640,18.360; P＜0.05) after treatment in treatment group.In control group,the differences of PSV (t=2.090,-2.550,-2.100) and PI (t=-2.310,-2.230,-4.490) of OA,CRA and PCA between before and after treatment were not statistically significant (P＞0.05) ; but the differences of RI of OA,CRA and PCA between before and after treatment was statistically significant (t=2.970,2.160,2.690μ P＜0.05).Compared with control group,PSV (t=2.632,2.135,5.364) and PI (t=3.251,2.432,4.243) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=3.664,2.938,4.324; P＜0.05) after treatment in treatment group.Conclusion Lowering intraocular pressure treatment can improve the ocular hemodynamics in NAION patients.
ABSTRACT
The characteristics of non-arteritic anterior ischemic optic neuropathy (NAION) include sudden decline of visual acuity, sector-shaped visual field defect connected with the physiological blind spot or hemi-visual field defect, and optic disc edema. Early angiographic abnormalities of optic disc and peripapillary choroidal circulation are important cues for the diagnosis. Angiography combined with visual field test can make the diagnosis more accurate. The pathological mechanism and process of NAION and ischemic cardiovascular/cerebrovascular disease are essentially the same. There are several critical issues in this field we need focus on, including strengthening the cooperation with relevant professional disciplines; improving the ocular ischemia through drugs, intervention and other means; preventing more serious cardiovascular events and intervening in a number of high-risk populations to reduce the incidence of AION.
ABSTRACT
Objective To observe the results of multifocal visual evoked potential (mfVEP) examination in patients with anterior ischemic optic neuropathy (AION) before and ater treatment,and to probe its clinical significance.Methods A total of 90 patients (90 eyes) with AION were examined by mfVEP;the second-order reaction of mfVEP was analyzed.The reaction was divided into upper and lower hemi-field of visual field,or 1 / 4 quadrant visual field (superior nasal,inferior nasal,superior temporal,and inferior temporal).The sum of waves of each response was analyzed and the results in various regions were compared.The features of wave configuration was compared between the AION eyes and the contralateral eye,and between the AION eyes before and after treatment.Results The amplitude and latency of P-wave of mfVEP was 0.198±0.033 and 100.197±7.354 respectively in AION eyes before treatment,and was 0.271±0.024 and 98.567±6.794 in the contralateral eyes;the difference was significant (t=16.556,18.330;P＜0.01).The amplitude and latency of P-wave of mfVEP was 0.229±0.016 and 100.104±10.603 respectively in AION eyes after treatment,which differed much from that before the treatment (t=13.649,8.858;P＜0.01) and also from that of the contralateral eyes (t=13.649,8.858;P＜0.01).Conclusions The amplitude and latency of P-wave of mfVEP may accurately reflect the recovery of local optic nerve damage in AION eyes before and after treatment with good repeatability.AION can be used as a new method for AION diagnosis and detection of the prognosis.