Clinical Characteristics of Non-arteritic Anterior Ischaemic Optic Neuropathy and Clinical Outcomes of Systemic Corticosteroid Therapy

Abstract

Purpose: Describe the clinical characteristics of the disease and preliminarily evaluate the clinical outcomes of systemic corticosteroid therapy for the management of non-arteritic anterior ischaemic optic neuropathy. Methods: This is a cross-sectional descriptive study, conducted on 20 patients examined and treated at Vietnam National Institute of Ophthalmology from March 2021 to December 2023. Outcomes: The study included 20 eyes in 20 patients (8 men and 12 women), the disease mainly started after age 50 (80%). Regarding risk factors for disease onset, 4/20 (20%) patients had a history of vascular disease (diabetes mellitus, hypertension), and 20/20 (100%) patients had a second eye (normal eye) with a crowded, narrow optic disc structure, with no cup. 70% of patients came to the doctor within 1 week of illness and vision below 20/100 accounted for 80%. All patients had an inferior altitudinal defect, with moderate to severe papilledema accounting for 95%. The duration of management with systemic corticosteroids between the time when the disease was detected and when the papilledema withdraws ranging from 1 to 3 weeks (average 2 weeks) accounted for 85%. After 6 months of management, 70% of patients maintained their visual acuity, and 25% of them had their visual acuity increased by 3 rows. 55% of patients preserved their visual field and 35% of them had their visual field improved. Conclusion: Understanding the clinical characteristics helped doctors diagnose, treat, and prognose the disease. The mean duration of using oral corticosteroids at a dose of 48 mg/day was 2 weeks ranging from when the disease was detected to when the papilledema was withdrawn. Although the study did not have a control group, initially it could illustrate that oral corticosteroids had the effect of cutting off the pathological spiral, preventing the progression of the disease, and partially improving vision.