Clinical Profile of Patients with Nonarteritic Anterior Ischemic Optic Neuropathy Presented to a Referral Center from 2003 to 2008

Background: We conducted this study to report the demographics and clinical profile of patients with nonarteritic anterior ischemic optic neuropathy referred to a referral neuroophthalmology center in Iran. Methods: During a five-year period, 107 patients with nonarteritic anterior ischemic optic neuropathy were studied. A detailed history of previous or current systemic diseases was obtained and a complete ophthalmic evaluation including best corrected visual acuity, color vision testing, and computerized perimetry was performed. Results: Sixty-six men and 41 women with a mean±SD age of 52.7±10.3 (range: 30 – 80) years were studied. Most (62.2%) of the patients aged more than 50 years. Twenty-two (20.5%) patients had had an episode of nonarteritic anterior ischemic optic neuropathy in the fellow eye. Overall, 51 (47.7%) patients had no evidence of a previous or current systemic disease. Diabetes mellitus and hypertension were reported in 40.1% and 26.1% of the patients, respectively. The best corrected visual acuity was 20/200 or worse in 43 (40.1%) eyes and 20/40 or better in 43 (40.1%) eyes. The best corrected visual acuity was significantly better in nondiabetic patients (0.62±0.69 LogMAR) than diabetics (0.96±0.84, P=0.03). The visual field analysis of reliable fields (76 eyes) revealed that the mean deviation ranged from -32.6 to -1.3 dB with a mean±SD of -19.7±8.08 dB. Diffuse defect was the most prevalent defect detected on 36.8% of visual fields of the study eyes followed by inferior altitudinal defect (26.3%). In the fellow eyes, without any evidence of prior optic nerve problem, inferior and superior arcuate scotoma were found in 30% and 20% of the eyes, respectively. Conclusion: Characteristics of nonarteritic anterior ischemic optic neuropathy patients in a population of Iranian patients were similar to nonarteritic anterior ischemic optic neuropathy as described in previous studies, with the exception of higher proportion of younger patients and a higher propensity for diabetes. Visual field defects were common in clinically normal fellow eyes.