Abstract
Purpose :
To estimate the incidence of arteritic anterior ischemic optic neuropathy (AAION) associated with giant-cell arteritis (GCA) among the patients with anterior ischemic optic neuropathy in single medical center in Korean, and suggest distinctive clinical features of AAION associated with GCA in the Korean patients based on our case-series and reported cases in the literature.
Methods :
Medical records were retrospectively reviewed in 142 patients who had visited Pusan National University Hospital as anterior ischemic optic neuropathy from January 2013 to August 2018. The patients were divided into 2 groups: AAION associated with GCA and non-arteritic ischemic optic neuropathy (NAION). In addition, we review the literature and identified all cases with AAION in Korean. We evaluated clinical data including initial and final best-corrected visual acuity, fundus photographs, Humphrey visual field testing results, fundus fluorescein angiography and contrast-enhanced magnetic resonance imaging, and compared with Caucasian patients.
Results :
Of the 142 patients, three (2.1%) were diagnosed as AAION and 139 (97.9%) were diagnosed as NAION. Five patients with AAION associated with biopsy-proven GCA in Korea were identified from the literature review. We found no difference in ay clinical features except for laterality, among the 7 patients, 4 had bilateral involvement of AAION. Moreover, perioptic nerve sheath enhancement was observed in two patients in our Korean cohort.
Conclusions :
AAION associated with GCA is very rare condition in Korea, however, GCA should be considered in every single case of ischemic optic neuropathy patients because AAION had poor visual outcome, sometimes bilaterally. In addition, GCA can be associated with optic perineuritis, suspicion of GCA should be included during OPN work-up process.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.