Evaluation and management of nonarteritic anterior ischemic optic neuropathy: a national survey.

Expert opinion Neuro-ophthalmologists Nonarteritic anterior ischemic optic neuropathy (NAION) Optic neuropathy

Journal

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

ISSN: 1435-702X

Titre abrégé: Graefes Arch Clin Exp Ophthalmol

Pays: Germany

ID NLM: 8205248

Informations de publication

Date de publication:
15 May 2024

Historique:

received: 29 01 2024

accepted: 09 05 2024

revised: 28 04 2024

medline: 15 5 2024

pubmed: 15 5 2024

entrez: 15 5 2024

Statut: aheadofprint

Résumé

The evaluation and management of Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) lacks standardized guidelines. This study aimed to investigate the real-world practices of neuro-ophthalmologists in the evaluation and management of typical NAION cases. A national survey, conducted between 2019 and 2021, involved all practicing neuro-ophthalmologists. A structured questionnaire assessed their approach to risk factor evaluation and treatment of NAION, with 19 questions about risk factors and six questions concerning treatment and prevention of fellow-eye involvement. Thirty-six out of 37 neuro-ophthalmologists participated. Most physicians referred patients for evaluation of the following risk factors: obstructive sleep apnea (83.3%), diabetes mellitus (83.3%), hypertension (77.7%), dyslipidemia (72.2%), and optic disc drusen (38.8%). However, there was considerable variation in the choice of diagnostic tests recommended. Furthermore, nearly 47% recommended an embolism workup. Regarding treatment, the majority (91%) did not recommend routine treatment for NAION, although in 16.7%, high-dose corticosteroids were occasionally prescribed. Secondary prevention with aspirin (80.6%), smoking cessation advice (86.1%), and advising against erectile dysfunction medications for men (80.6%) were common recommendations. While the risk factors associated with NAION are well-reported, there is a lack of uniformity on which tests should be ordered to evaluate these risk factors. Most neuro-ophthalmologists concur that routine treatment for NAION is not warranted, but not unanimously. Future studies to develop a consensus guideline for post-NAION work-up and management recommendations may assist in the detection and management of preventable risk factors.

Identifiants

DOI: 10.1007/s00417-024-06512-y PMID: 38748211

pubmed: 38748211

doi: 10.1007/s00417-024-06512-y

pii: 10.1007/s00417-024-06512-y

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

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