Visual outcome following bilateral non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis
Date
2017
Type:
Artículo
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6
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Authors
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Journal Title
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Publisher
BioMed Central
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Abstract
Background: Many patients who suffer unilateral non-arteritic anterior ischemic optic neuropathy (NAION) will
eventually develop the same condition in their other eye, worrying them about losing vision in both eyes. The purpose
of this meta-analysis is to determine whether it is possible to predict the visual outcome of the consecutive NAION
event based on initial presentation and to compare mean visual loss of firstly versus secondly affected eyes.
Methods: A systematic review and meta-analysis of studies published between January 1st 1966 and May 31st 2016
reporting on visual acuity and/or visual field loss of both affected eyes, measured either at presentation or follow-up
following bilateral NAION.
Results: Ten studies were included in the meta- analysis of visual acuity, including 9 retrospective reports and one
randomized clinical trial, and five retrospective studies were included in visual field meta-analysis. A significant
correlation exists for visual acuity (R = 0.387, P < 0.001) in both eyes of the same patient following bilateral NAION, and
also for visual field loss (R = 0.445, P < 0.001) in the two eyes. The calculated coefficient of determination (R2
) of 0.149
for visual acuity, and 0.198 for visual field loss indicates that for any given individual suffering from unilateral NAION
only 15% of visual acuity and 20% of visual field loss in the secondly affected eye can be explained by these outcomes
in the first eye. In addition, there was no difference in mean visual outcome of the first versus second NAION events
(standardized mean differences of visual acuity 0.008, P = 0.890; and visual field loss, −0.019, P = 0.819).
Conclusion: Even though a weak connection exists between visual outcome in both eyes following bilateral NAION it
is still impossible to predict with certainty the visual outcome of a sequential contralateral NAION event based on the
severity of visual loss in the first affected eye. Measures often taken after the first event are ineffective in improving the
visual outcome of a second event should it occur.
Description
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Citation
Keren S, Zanolli M, Dotan G. Visual outcome following bilateral non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. BMC Ophthalmol. 2017 Aug 24;17(1):155
Keywords
Non-Arteritic anterior ischemic optic neuropathy (NAION), Meta-analysis