Clinical Features in Anterior Ischemic Optic Neuropathy

Jun, B K; Kim, D S; Ko, M K

Abstract

Anterior ischemic optic neuropathy[AION] is known to be a disease that primarily affects middle-aged and older population. It initially presents with udden painless loss of vision and related visual field defect. This study was conducted to investigate the clinical features of AION. We retrospectively reviewed the medical records of 28 patients[30 eyes] with AION. The clinical features including the onset age, initial and final visual acuity, types of visual field defects at initial attack, presence of 7 associated systemic diseases, and erythrocyte sedimentation rate[ESR] level were evaluated. Fifteen patients were male and 13 were female, and the mean age was 53 years[minimum, 26, and maximum, 88]. The initial visual acuity was less than 0.5 in 19 eyes[63.3%], and 0.5 or better in 11 eyes[36.7%]. The final visual acuity was less than 0.5 in 13 eyes[43.3%], and 0.5 or better in 17 eyes[56.7%]. In visual field defects, the altitudinal field defect was most common and was found in 13 eyes[43.3%]. Also there were arcuate scotoma, quadrantanopsia, and central or paracentral scotoma. In 19 patients[67.8%] there were combined systemic disorders. Among them systemic hypertension was found in 13 patients[68.5%], diabetes mellitus in 4 patients[21%], and rheumatoid arthritis in 2 patients[10.5%]. Elevation of ESR was found in 7 patients[25.0%]. These results suggest that AION has various clinical features and some systemic diseases may act as predisposing factors. The various degrees of visual outcome including visual acuity and visual field defects may be related to the degree of circulatory insufficiency within the anterior optic nerve head.