Abstract
Purpose: :
The purpose of this study was to describe the epidemiology of Non-arteritic Anterior Ischemic Optic Neuropathy (NAION) in a referral center in Mexico-City.
Methods: :
The clinical records of all patients diagnosed with NAION at the Ophthalmology Institute "Conde de Valenciana" in Mexico-City in the period between January 2002 and August 2007 were reviewed. Patients with an arteric ethiology, CNS pathology, previous history of toxic exposure, trauma,ophthalmologic surgery or concomitant ophthalmic disease were excluded. Patients with incomplete records were elliminated.
Results: :
843 records of patients with a diagnosis of NAION (389 female and 454 male) were annalyzed. Mean age at diagnosis was 61.6±14.2 years. Forty two% of patients had a diagnosis of diabetes mellitus with a mean disease progression of 12 years at the time of NAION diagnosis. Thirty five% of patients had hypertension with a mean progression of 6.3 years. Twenty one% patients had a history of smoking and 10% of occasional alcohol intake. The initial complaint was sudden decrease in visual acuity in 25.0% of patients (patients presenting with an acute NAION event), progressive visual loss in 57.1% of patients (which presented to our referral center only after the acute NAION event), visual field defects in 10.7% of patients and 7.1% were asymptomatic at the time of diagnosis. Mean time from visual loss onset was 9.7days in the acute NAION group and 24 months in the chronic NAION group. Initial visual acuity was 20/50 in the acute NAION group and 20/80 in the chronic NAION group. Color vision dysfunction was found in 27.2% of eyes with acute NAION and in 67.7% of eyes with chronic NAION. Funduscopic findings were generalized pallor of the optic disk in 45.2% of eyes, sectorial pallor in 23.8% of eyes and disc edema in 26.1% of eyes. Optic disk pallor correlated to the group of progressive visual loss in which the patient presented after the acute NAION event, and edema correlated to the group with acute NAION. Campimetric abnormalities in the acute NAION group included cecocentral scotoma and altitudinal defect. Visual field abnormalities in chronic NAION were typically altitudinal defects The mean blood glucose level at time of diagnosis was 165.4 mg/dL, mean total cholesterol was 211 mg/dL and mean triglycerydes were 200.1 mg/dL.
Conclusions: :
We provide an epidemiologic description of Non-arteritic Anterior Ischemic Optic Neuropathy in an Ophthalmology referral center.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • neuro-ophthalmology: optic nerve • ischemia