May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Functional and Anatomic Outcomes of Intravitreal Triamcinolone Acetonide for Non-Arteritic Anterior Ischemic Optic Neuropathy
Author Affiliations & Notes
  • R. A. Bueno-Garcia
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • J. B. Kerrison
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • R. A. Garcia
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • V. Alfaro, III
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • E. P. Jablon
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • M. Rodriguez-Fontal
    Retina Consultants, Charleston Neuroscience Institute, Charleston, South Carolina
  • Footnotes
    Commercial Relationships  R.A. Bueno-Garcia, None; J.B. Kerrison, None; R.A. Garcia, None; V. Alfaro, None; E.P. Jablon, None; M. Rodriguez-Fontal, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 6008. doi:https://doi.org/
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      R. A. Bueno-Garcia, J. B. Kerrison, R. A. Garcia, V. Alfaro, III, E. P. Jablon, M. Rodriguez-Fontal; Functional and Anatomic Outcomes of Intravitreal Triamcinolone Acetonide for Non-Arteritic Anterior Ischemic Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6008. doi: https://doi.org/.

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

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Abstract

Purpose: : Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is an infarction of the optic nerve head caused by inadequate perfusion of the posterior ciliary arteries. It is postualted that vision loss in NAION occurs from primary ischemia to the optic nerve and secondary compression from compartmentalized edema. It is postulated that pharmacologic decompression of optic nerve edema with intravitreal high dose corticosteroids might improve visual outcome. The aim of this study was to evaluate the used of triamcinolone acetonide in the treatment of NAION.

Methods: : We conducted a retrospective interventional clinical case series of eight patients to review the effects of 4 mg dose of intravitreal triamcinolone acetonide as a treatment of NAION. A comprehensive ophthalmic evaluation was performed, including recording of visual acuity, visual fields with a Goldmann perimeter, and intraocular pressure; slitlamp examination of the anterior segment; ophthalmoscopy; color fundus photography; and in acute cases, fluorescein fundus angiography.

Results: : Visual acuity improved in six (85%) patients with a mean improvement of 3.5 lines. Two patients (25 %) had loss of visual acuity with a mean worsening of 4 lines. Among six patients with improved visual acuity, visual field (mean deviation) as determined by kinetic perimetry improved slightly in one patient (12.5 %) and showed no significant overall change in five patients (62.5 %). Two patients with worsening visual acuity demonstrated a relative inferior altitudinal defect that changed to an absolute inferior altitudinal defect during follow up. An inferior altitudinal visual field defect was the most common pattern in our NAION patients (four eyes). One patient developed an elevated intraocular pressure (28 mmHg) that responded to well to topical glaucoma therapy

Conclusions: : Intravitreal steroid use in NAION has shown no benefit in one small case control study of three patients. In the present study of eight eyes, the benefit of intravitreal steroids could not clearly be demonstrated. Further studies are necessary in order to document possible benefit.

Keywords: neuro-ophthalmology: optic nerve • ischemia • visual impairment: neuro-ophthalmological disease 
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