June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Characterization of retinal function, microstructure, microvascular networks, and microcirculation in acute non-arteritic anterior ischemic optic neuropathy
Author Affiliations & Notes
  • Amanda D Henderson
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
    Neuro-Ophthalmology, Wilmer Eye Institute/Johns Hopkins University, Baltimore, Maryland, United States
  • Samuel P Burke
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Pedro Monsalve
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Giovanni Gregori
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Hong Jiang
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Vittorio Porciatti
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Byron L Lam
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Luis E Vazquez
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Jianhua Wang
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Amanda Henderson, None; Samuel Burke, None; Pedro Monsalve, None; Giovanni Gregori, Carl Zeiss Meditech (F), F & P (F); Hong Jiang, None; Vittorio Porciatti, None; Byron Lam, None; Luis Vazquez, None; Jianhua Wang, Optical Imaging Ltd. (C)
  • Footnotes
    Support  NIH-NEI R43 EY023460, NIH-NEI RO1 EY019077, NIH center grant P30-EY014801, unrestricted grant to Bascom Palmer Eye Institute from Research to Prevent Blindness, Inc.
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3858. doi:
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      Amanda D Henderson, Samuel P Burke, Pedro Monsalve, Giovanni Gregori, Hong Jiang, Vittorio Porciatti, Byron L Lam, Luis E Vazquez, Jianhua Wang; Characterization of retinal function, microstructure, microvascular networks, and microcirculation in acute non-arteritic anterior ischemic optic neuropathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3858.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of acute optic neuropathy in patients over age 50, causing often-devastating effects on vision. However, understanding of the pathophysiology of NAION is limited. We performed a prospective clinical study to generate the first comprehensive characterization of retinal microstructure, microcirculation, microvascular networks, and ganglion cell function in patients with acute NAION.

Methods : 5 patients (3 female/2 male, age range 46-70, mean age 59) with acute NAION underwent pattern electroretinogram (PERG), retinal functional imaging (RFI), optical coherence tomography angiography (OCTA), and ultra high resolution optical coherence tomography (UHR-OCT) at intervals of 2 weeks, 1 month, and 3 months after the onset of vision loss. Images were processed according to previously established techniques. Results were evaluated using Microsoft Excel.

Results : 5 patients with acute NAION were enrolled and underwent imaging. 2 patients withdrew after the 1-month imaging session, and 3 patients completed imaging. RFI demonstrated a trend toward decreasing retinal blood flow velocity over time after NAION. PERG showed decreased retinal ganglion cell function that improved over time while remaining subnormal. Compared with a normative database of 30 patients (age range 25-79, mean 39), amplitude was diminished, whereas phase remained comparable to controls. PERG amplitude of NAION patients was 29%, 32%, and 36% (p=0.00008, 0.0002, and 0.0000001, respectively) that of controls at the 2-week, 1-month, and 3-month imaging sessions, whereas phase represented 101%, 100%, and 98% of controls at the same time intervals (not statistically significant). OCTA demonstrated an increase in superficial microvascular network complexity after NAION, and a decrease in deep microvascular network complexity. Retinal nerve fiber layer and ganglion cell layer thickness declined between weeks 2 and 4, then plateaued. Time point comparisons did not reach statistical significance.

Conclusions : Results demonstrate the feasibility of comprehensive characterization of NAION using a full suite of advanced ophthalmic imaging techniques. A larger sample size and comparison to age-matched controls will be required for further correlations to be established.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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