Change of Retinal Nerve Layer Thickness in Non-Arteritic Anterior Ischemic Optic Neuropathy Revealed by Fourier Domain Optical Coherence Tomography

Curr Eye Res. 2016 Aug;41(8):1076-1081. doi: 10.3109/02713683.2015.1084640. Epub 2015 Nov 18.


Purpose: To examine the changes of non-arteritic anterior ischemic optic neuropathy (NAION) by serial morphometry using Fourier domain optical coherence tomography (FD-OCT).

Materials and methods: Retrospective study in patients with newly diagnosed NAION (n=33, all unilateral) and controls (n=75 unilateral NAION patients with full contralateral eye vision) who underwent FD-OCT of the optic disk, optic nerve head (ONH), and macula within 1 week of onset and again 1, 3, 6, and 12 months later. The patients showed no improvement in vision during follow-up.

Results: Within 1 week of onset, all NAION eyes exhibited severe ONH fiber crowding and peripapillary retinal nerve fiber layer (RNFL) edema. Four had subretinal fluid accumulation and 12 had posterior vitreous detachment (PVD) at the optic disc surface. Ganglion cell complex (GCC) and RNFL thicknesses were reduced at 1 and 3 months (p < 0.05), with no deterioration thereafter. Initial RNFL/GCC contraction magnitude in the superior hemisphere correlated with the severity of inferior visual field deficits.

Conclusions: NAION progression is characterized by an initial phase of accelerated RNFL and GCC deterioration. These results reveal that the kinetic change of neural retina in NAION and may have implication on the time window for treatment of NAION. FD-OCT is useful in the evaluation of NAION.

Keywords: Fourier domain optical coherence tomography; ganglion cell; non-arteritic anterior ischemic optic neuropathy; retinal nerve fiber layer; visual field.

MeSH terms

  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Optic Disk / pathology*
  • Optic Neuropathy, Ischemic / diagnosis*
  • Retinal Ganglion Cells / pathology*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Visual Acuity*
  • Visual Fields*