• AAION
• AION
• ION
• NAAION
• NAION
• PION
• ischemic optic neuropathy
• management
• pharmacotherapy

• Corpus callosum
• non-arteritic ischemic optic neuropathy
• optic disc edema

• Humans
• Optic Neuropathy, Ischemic/diagnosis
• Female
• Corpus Callosum/pathology
• Corpus Callosum/diagnostic imaging
• Corpus Callosum/blood supply
• Aged, 80 and over
• Visual Fields/physiology
• Magnetic Resonance Imaging
• Visual Acuity
• Brain Ischemia/diagnosis
• Tomography, Optical Coherence
• Optic Disk/blood supply
• Optic Disk/pathology

• Anterior ischemic optic neuropathy
• Chronic hemodialysis
• Kidney replacement therapy
• Pediatric
• Posterior ischemic optic neuropathy
• Sudden vision loss

• Male
• Humans
• Child
• Child, Preschool
• Optic Neuropathy, Ischemic/complications
• Optic Neuropathy, Ischemic/diagnosis
• Renal Dialysis/adverse effects
• Glomerulosclerosis, Focal Segmental/complications
• Kidney Failure, Chronic/therapy
• Anemia/etiology

• nonarteritic anterior ischemic optic neuropathy
• optical coherence tomography
• peripapillary retinal nerve fiber layer thickness
• visual acuity
• visual field
• visual prognosis

• funding

• eye manifestations
• ocular ischemic syndrome

• Humans
• Optic Neuropathy, Ischemic/diagnosis
• Optic Neuropathy, Ischemic/etiology
• Diagnosis, Differential
• Tomography, Optical Coherence/methods
• Papilledema/diagnosis
• Edema
• Diabetes Mellitus
• Hemorrhage/diagnosis

• NA-AION pathophysiology
• NA-AION risk factors
• NA-AION treatment options
• ischemic optic neuropathy (ION)
• non-arteritic anterior ischemic optic neuropathy (NA-AION)

• Anterior ischemic optic neuropathy
• Complexe des cellules ganglionnaires
• Cup/Disc ratio
• Fellow eye
• Fibres nerveuses rétiniennes
• Ganglion cell complex
• Indice cup/disc
• Neuropathie optique ischémique antérieure aiguë
• Optical coherence tomography
• Retinal nerve fiber layer
• Tomographie par cohérence optique
• Œil adelphe

• Humans
• Female
• Middle Aged
• Optic Neuropathy, Ischemic/etiology
• Visual Acuity
• Vision Disorders/etiology
• Fundus Oculi
• Diabetes Mellitus

• Arteritic ION
• disc-at-risk
• ischemic optic neuropathy
• non-arteritic ION

• Levodopa
• Sinemet
• intravitreal injection triamcinolone acetonide
• nonarteritic anterior ischemic optic neuropathy

Giant cell arteritis (GCA) is a primary autoimmune vasculitis that specifically affects medium-sized extracranial arteries, like superficial temporal arteries (TAs). The most important data to be considered for the ultrasound (US) diagnosis of temporal arteritis are stenosis, acute occlusions and “dark halo” sign, which represent the edema of the vascular wall. The vessel wall thickening of large vessels in GCA can be recognized by the US, which has high sensitivity and is facile to use. Ocular complications of GCA are common and consist especially of anterior arterial ischemic optic neuropathies or central retinal artery occlusion with sudden, painless, and sharp loss of vision in the affected eye. Color Doppler imaging of the orbital vessels (showing low-end diastolic velocities and a high resistance index) is essential to quickly differentiate the mechanism of ocular involvement (arteritic versus non-arteritic), since the characteristics of TAs on US do not correspond with ocular involvement on GCA. GCA should be cured immediately with systemic corticosteroids to avoid further visual loss of the eyes.

• glaucoma
• mitochondria
• optic disc drusen
• optic neuropathy
• oxidative stress
• redox dysregulations
• retinal ganglion cell

• arteritic anterior ischemic optic neuropathy
• giant cell arteritis
• loss of vision
• unilateral
• vasculitis
• visual loss

• Non-arteritic anterior ischemic optic neuropathy
• Optical coherence tomography angiography
• Peripapillary vascular density

• Anti-aquaporin-4 antibody
• anti-myelin oligodendrocyte glycoprotein antibody
• interhemispheric functional connectivity
• optic neuritis
• resting-state functional magnetic resonance imaging
• voxel-mirrored homotopic connectivity

• Choroidal thickness
• Ischemic optic neuropathy
• Macular thickness
• Retinal nerve fiber layer
• Retinal vascular caliber

To evaluate the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with non-arteritic anterior ischemic optic neuropathy (NAION).

Fifty-six patients with NAION and 60 age-sex matched healthy controls were included in the study. Demographic characteristics and laboratory findings of the patients and the controls were obtained from the electronic medical records. NLR, PLR, MLR, and SII were calculated and compared between the groups. Cutoff values were also determined.

Neutrophil, monocyte and platelet counts were higher in the NAION group than in the control group, but the difference was not statistically significant (p > 0.05). The mean NLR and SII were higher in the NAION group than in the control group (p = 0.004 and p = 0.011, respectively). In the receiver operating characteristic curve analysis, the areas under the curve for NLR were 0.67, and NLR >1.79 predicted NAION with a sensitivity of 71% and specificity of 59%. The areas under the curve for SII was 0.66, and SII of >417 predicted NAION with a sensitivity of 71% and specificity of 49%. There was no significant difference in PLR and MLR between the groups (p = 0.105 and p = 0.347, respectively).

The current study demonstrated that NAION patients had increased NLR and SII levels compared with control subjects. Elevated NLR and SII might serve as readily available inflammatory predictors in NAION patients.

• : Monocyte-to-lymphocyte ratio
• Neutrophil-to-lymphocyte ratio
• Non-arteritic ischemic optic neuropathy
• Platelet-to-lymphocyte ratio
• Systemic immune-inflammation index

Non-arteritic anterior ischemic optic neuropathy (NAION) is a rare complication following acute bleeding. Patients present with varying vision loss and visual field defects. NAION is more commonly developed in patients with systemic disorders that may affect normal blood flow such as hypertension and diabetes. In this case, we report a 54-year-old man who complained of vision blurring following an episode of acute gastric bleeding. This report aims to review the pathology of this condition and present the findings of newer non-invasive imaging modalities of the vascular layers of the posterior pole of the eye like optical coherence tomography angiography (OCTA), which facilitates the proper diagnosis and prognosis of such cases. Finally, we present the management options for this patient with antiplatelet treatment.

• anterior ischemic optic neuropathy
• hypoperfusion
• hypovolemia
• optic nerve

• C reactive protein
• erythrocyte sedimentation rate
• microinflammation
• non-arteritic anterior ischemic optic neuropathy
• optic neuropathy

• Anemia
• hypoxia
• optic nerve
• perioperative
• posterior ischemic optic neuropathy
• tissue perfusion pressure

To explore the effects of enhanced external counterpulsation (EECP) and its underlying influencing factors in nonarteritic anterior ischemic optic neuropathy (NAION) patients.

Patients at Zhongshan Ophthalmic Center with recent-onset (< 8 weeks) NAION were retrospectively recruited. The patients had decided whether or not they would undergo EECP treatment, and the patients who declined were included in the control group. The effectiveness of EECP was evaluated by comparing the visual function and fellow eye involvement in patients with and without EECP treatment.

In total, 61 patients (76 eyes) were included. Twenty-nine patients (37 eyes) underwent EECP treatment, while 32 patients (39 eyes) were included in the control group. Mean time from NAION onset to EECP initiation was 27.59 ± 16.70 days. In the EECP group, the mean EECP duration was 31.57 ± 18.45 days. EECP was well tolerated by all patients. However, there was no significant difference in visual function between the EECP and control groups. Furthermore, there was no evidence of the effectiveness of EECP in the subgroup analysis of patients with different systemic health conditions. Among the 42 patients with monocular NAION, the sequential attack rate was comparable between the EECP (27.78%) and control (25.00%) groups.

This study is the first nonrandomized controlled study to evaluate the effectiveness of EECP in NAION patients. Unfortunately, we failed to demonstrate the effectiveness of EECP in NAION at the 6-month follow-up. Any further application of EECP in NAION patients should be cautious.

• Enhanced external counterpulsation
• Nonarteritic anterior ischemic optic neuropathy
• Visual acuity
• Visual field

• Nonarteritic anterior ischemic optic neuropathy (NAION)
• Retinal nerve fiber layer thickness
• Visual acuity
• Visual field

• Non-arteritic anterior ischemic optic neuropathy
• arteritic anterior ischemic optic neuropathy
• optical coherence tomography (OCT)
• quantitative optical coherence tomography angiography (OCTA)
• vessel density
• vessel tortuosity

To assess the use of temporal artery biopsy (TAB) in diagnosing giant cell arteritis (GCA) and to evaluate patients' clinical and laboratory characteristics.

We conducted a retrospective chart review of patients with suspected GCA who underwent TAB and had complete workup in a tertiary center in Iran between 2008 and 2017. The 2016 American College of Rheumatology (ACR) revised criteria for early diagnosis of GCA were used for each patient for inclusion in this study.

The mean age of the 114 patients in this study was 65.54 ± 10.17 years. The mean overall score according to the 2016 ACR revised criteria was 4.17 ± 1.39, with 5.82 ± 1.28 for positive biopsies and 3.88 ± 1.19 for negative biopsies (p <0.001). Seventeen patients (14.9%) had a positive biopsy. Although the mean post-fixation specimen length in the biopsy-positive group (18.35 ± 6.9 mm) was longer than that in the biopsy-negative group (15.62 ± 8.4 mm), the difference was not statistically significant (P = 0.21). There was no statistically significant difference between the groups in terms of sex, serum hemoglobin, platelet count, and erythrocyte sedimentation rate. There were statistically significant differences between the biopsy-negative and biopsy-positive groups with respect to patients' age and C-reactive protein level (P< 001 and P = 0.012, respectively).

The majority of TABs were negative. Reducing the number of redundant biopsies is necessary to decrease workload and use of medical services. We suggest that the diagnosis of GCA should be dependent on clinical suspicion.

• Giant Cell Arteritis
• Temporal Arteritis
• Temporal Artery Biopsy
• Anterior Ischemic Optic Neuropathy

• Retina
• cell therapy
• endothelial progenitors
• induced pluripotent stem cells
• mesenchymal stem cells
• retinal ischemia

• Animals
• Cell- and Tissue-Based Therapy/methods
• Humans
• Ischemia/complications
• Ischemia/therapy
• Regeneration/physiology
• Retinal Diseases/etiology
• Retinal Diseases/therapy
• Retinal Vessels/physiopathology

• MC_PC_17175 Medical Research Council
• MR/S036695/1 Medical Research Council
• PG/19/50/34436 British Heart Foundation

An important task of pharmacology is to find effective agents to improve retinal microcirculation and resistance to ischemia. The purpose of the study is to pharmacologically evaluate the retinoprotective effect of 2-ethyl-3-hydroxy-6-methylpyridine nicotinate in a rat model of retinal ischemia–reperfusion. A retinal ischemia–reperfusion model was used, in which an increase in intraocular pressure (IOP) to 110 mmHg was carried out within 30 min. The retinoprotective effect of 2-ethyl-3-hydroxy-6-methylpyridine nicotinate at a dose of 3.8 mg/kg, in comparison with nicotinic acid at a dose of 2 mg/kg and emoxipine at a dose of 2 mg/kg, was estimated by the changes in the eye fundus during ophthalmoscopy, the retinal microcirculation level with laser Doppler flowmetry (LDF), and electroretinography (ERG) after 72 h of reperfusion. The use of 2-ethyl-3-hydroxy-6-methylpyridine nicotinate prevented the development of ischemic injuries in the fundus and led to an increase in the retinal microcirculation level to 747 (median) (lower and upper quartiles: 693;760) perfusion units (p = 0.0002) in comparison with the group that underwent no treatment. In the group with the studied substance, the b-wave amplitude increased significantly (p = 0.0022), and the b/a coefficient increased reliably (p = 0.0002) in comparison with the group with no treatment. Thus, 2-ethyl-3-hydroxy-6-methylpyridine nicotinate has established itself as a potential retinoprotector.

• 2-ethyl-3-hydroxy-6-methylpyridine nicotinate
• electroretinography
• laser Doppler flowmetry
• ophthalmoscopy
• retinal ischemia

Previous case reports have demonstrated the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD).

A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the study period were enrolled in the study cohort. Enrollees were divided into three groups according to the categorized levels of injection number (first level: < 10 times, second level: 10–15 times, and third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyses were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to the different levels of injection numbers. The confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma).

In total, the study cohort included 77,210 patients. Of these, 26,520, 38,010, and 12,680 were in the first-, second-, and third-level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second- and third-level groups were 1.91 (95% confidence interval [CI], 1.32–2.76) and 2.20 (95% CI, 1.42–3.43), respectively, compared with those in the first-level group.

Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections have a significantly higher risk of developing ION compared with individuals who receive a lower number of injections.

• Antivascular endothelial growth factor
• Cohort study
• Intravitreal injection
• Ischemic optic neuropathy
• National Health Insurance Research Database
• Neovascular age-related macular degeneration
• Risk factor

• inflammation
• neutrophil-to-lymphocyte ratio
• ocular diseases
• publication

• optic nerve
• vision
• visual pathway

The aim of this study is to report the relative incidence of arteritic anterior ischemic optic neuropathy (AAION) associated with giant-cell arteritis (GCA) in a single-center and evaluate the clinical features of AAION in Korean patients.

The medical records of patients with presumed AION who visited our hospital from January 2013 to August 2018 were examined retrospectively. The patients were divided into two groups: AAION associated with GCA, and non AION (NAION). We additionally reviewed the literature and identified all cases of AAION in Korean and Caucasian patients. We evaluated the clinical data including the initial and final best-corrected visual acuities, fundus photographs, visual field tests, fluorescein angiography, and contrast-enhanced MRI, and compared the data with those for Caucasian patients in the literature.

Of the 142 patients with presumed AION, 3 (2.1%) were diagnosed with AAION and 139 (97.9%) were diagnosed with NAION. Seven Korean patients with AAION associated with GCA were identified in our data and the literature review. We found no difference in any clinical features other than laterality: four of the seven Korean patients had bilateral involvement. Moreover, the optic nerve sheath was enhanced in two of our Korean patients.

AAION associated with GCA is a very rare condition compared to NAION in Korea. However, GCA should be considered in all cases of ischemic optic neuropathy because AAION is associated with poor visual outcome, and sometimes presents bilaterally.

• Korea
• anterior ischemic optic neuropathy
• arteritic anterior ischemic optic neuropathy
• giant-cell arteritis
• nonarteritic ischemic optic neuropathy
• optic nerve sheath enhancement

• Optic nerve head blood flow
• laser speckle flowgraphy
• optical coherence tomography angiography
• retinal function imager
• ultrasound colour Doppler imaging

• health insurance database
• hypoperfusion
• nonarteritic anterior ischaemic optic neuropathy
• obstructive sleep apnoea

Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of acute optic neuropathy in patients over 50 years of age, and many affected individuals are left with permanent visual deficits. Despite the frequency of NAION and its often devastating effects on vision, no effective treatment has been established. Further understanding of the acute vascular effects in NAION, using advanced ophthalmic imaging techniques like the retinal function imager, may shed light on potential treatment targets.

Five patients with acute NAION underwent retinal functional imaging within 2 weeks of the onset of their visual symptoms, and at 1 month and 3 months after onset. Average arteriolar and venular blood flow velocities were calculated for each eye at each time point. The Wilcoxon rank sum test was used to compare blood flow velocity results with a normative database.

The average arteriolar blood flow velocity in the normative group was 3.8 mm/s, and the average venular blood flow velocity was 3.0 mm/s, versus 4.1 mm/s and 2.7 mm/s, respectively, in the NAION-affected group at presentation. Average arteriolar blood flow increased slightly to 4.2 mm/s one month after the acute NAION event, then decreased to 3.8 mm/s three months after the event. Average venular blood flow velocity was 2.8 mm/s 1 month after the NAION event and 2.7 mm/s 3 months after the event. Differences in blood flow velocity between the NAION-affected and control groups were not statistically significant at any time point; however, there was a trend toward increasing blood flow velocity initially after an NAION, with a decrease over time.

This study demonstrates the feasibility of retinal function imaging to quantify macular blood flow velocity in patients with acute NAION. There were no statistically significant differences in blood flow velocity detected between NAION-affected eyes and healthy controls at any of the time points examined; however, there was a trend toward an increase in both arteriolar and venular BFV subacutely, then a decrease in the chronic phase after NAION, which could be suggestive of a mechanism of attempted compensation in the setting of acute ischemia.

• Blood flow velocity
• Non-arteritic anterior ischemic optic neuropathy
• Retinal functional imager

• Case-control studies
• Eye
• Nailfold videocapillaroscopy
• Systematic literature review
• Systemic sclerosis