Follow-up of arteriosclerosis-induced anterior ischemic optic neuropathy
Bertram, B.; Schulte-Stracke, U.; Wolf, S.; Schulte, K.; Arend, O.; Remky, A.; Reim, M.
Der Ophthalmologe Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 91(1): 81-85
1994
ISSN/ISBN: 0941-293X PMID: 8173256 Document Number: 433019
In 22 patients with acute arteriosclerotic anterior ischemic optic neuropathy (AION), examinations were conducted before the start of therapy and between 1 and 3 years later. In the acute stage of the disease the patients were treated with hemodilution for 10 days. The visual acuity improved from 0.2 to 0.4 (median). Compared with the visual acuity before therapy, at the follow-up 1-3 years later visual acuity had improved by 3 lines or more in 11 patients, remained stationary in 9 patients (+/- 1 line), and worsened in 2 patients by 3 lines or more. The visual fields (Goldmann) improved in 8 patients, did not change in 10 patients and worsened in 4 patients. After 1-3 years, 14 patients (64%) showed a sectorial pallor and 8 patients (36%) a diffuse pallor of the optic disc. Videofluorescein angiography revealed hypofluorescent discs in all patients. No difference in arm-retina time (ART) was found between the acute phase (13.0 +/- 3.3 s) and the examination 1-3 years later (13.1 +/- 2.2 s). ART was within normal limits in all patients. The arteriovenous passage time (AVP) dropped significantly, from 2.36 (+/- 0.81) s in the acute phase to 1.91 (+/- 0.56) s 1-3 years later. However, the AVP still did not fall to normal levels (1.45 +/- 0.40 s). Slowed retinal hemodynamics (AVP) with normal ART at the same time suggests a disturbance in microcirculation still present 1-3 years after the acute phase of AION. The rheological parameters (hematocrit, plasma viscosity, erythrocyte aggregation index) did not show any change between examinations.