Abstract
Purpose:
To evaluate the effect of a single intravitreal ranibizumab injection in eyes with acute nonarteritic ischemic optic neuropathy (NAION).
Methods:
In this retrospective clinical data analysis, 17 eyes of sixteen patients who experienced a visual loss with a duration of 15 days or less comprised the study group. In addition to standard opthalmic examination, retinal nerve fiber layer thickness (RNFLT) analysis with spectral domain OCT was also performed prior to injection, one, three, six months and one year after the injection.Two subgroups were also statistically analyzed according to the visual loss duration. (Group one, visual loss duration less than eight days and group two, visual loss duration between eight and 15 days.)
Results:
The mean time between visual loss and intravitreal injection was 7.5 days (Range, 2-15 days). Mean age of patients was 59 years (Range, 41-90 years). Male to female ratio was 6:10. After a single dose of ranibizumab injection, visual gain was noted in 14 of 17 study eyes. In two eyes, visual acuity was minimally reduced and no change was noted in the remaining eye with an initial visual acuity of hand motions. While preinjection mean best-corrected visual acuity (BCVA) was 1.45 ±0.88 logMar unit, postinjection mean BCVA was 1.00±0.68, 0.86 ±0.70, 0.80 ±0.71, 0.77 ±0.70 logMar unit respectively at the first week, first month, third month and first year. In all patients, the mean RNFLT dramatically decreased after the injection during the follow- up. While preinjection mean RNFLT was 210 ±38 µm, postinjection mean RNFLT was 162.11±40.2, 94±27, 71.23±22.5 and 57 ±18 µm respectively at the first week, first month, third month and first year. The improvement in visual acuity and RNFLT was better in the group of eyes with disease duration less than eight days but statitistical analysis was not significant when two groups were compared. No injection related complication was noted during the follow-up period.
Conclusions:
Intravitreal ranibizumab may be a promising treatment option in eyes with acute NAION .
Keywords: 561 injection •
629 optic nerve •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)