Korean J Ophthalmol.  2015 Dec;29(6):418-423. 10.3341/kjo.2015.29.6.418.

Differences between Non-arteritic Anterior Ischemic Optic Neuropathy and Open Angle Glaucoma with Altitudinal Visual Field Defect

• Han S
• Jung JJ
• Kim US

• KMID: 2363850
• DOI: http://doi.org/10.3341/kjo.2015.29.6.418

Abstract

PURPOSE
To investigate the differences in retinal nerve fiber layer (RNFL) change and optic nerve head parameters between non-arteritic anterior ischemic optic neuropathy (NAION) and open angle glaucoma (OAG) with altitudinal visual field defect.
METHODS
Seventeen NAION patients and 26 OAG patients were enrolled prospectively. The standard visual field indices (mean deviation, pattern standard deviation) were obtained from the Humphrey visual field test and differences between the two groups were analyzed. Cirrus HD-OCT parameters were used, including optic disc head analysis, average RNFL thickness, and RNFL thickness of each quadrant.
RESULTS
The mean deviation and pattern standard deviation were not significantly different between the groups. In the affected eye, although the disc area was similar between the two groups (2.00 +/- 0.32 and 1.99 +/- 0.33 mm2, p = 0.586), the rim area of the OAG group was smaller than that of the NAION group (1.26 +/- 0.56 and 0.61 +/- 0.15 mm2, respectively, p < 0.001). RNFL asymmetry was not different between the two groups (p = 0.265), but the inferior RNFL thickness of both the affected and unaffected eyes were less in the OAG group than in the NAION group. In the analysis of optic disc morphology, both affected and unaffected eyes showed significant differences between two groups.
CONCLUSIONS
To differentiate NAION from OAG in eyes with altitudinal visual field defects, optic disc head analysis of not only the affected eye, but also the unaffected eye, by using spectral domain optical coherence tomography may be helpful.

Keyword

Glaucoma; Ischemic optic neuropathy; Visual field tests

MeSH Terms

Aged
Arteritis/diagnosis
Diagnosis, Differential
Female
Glaucoma, Open-Angle/*diagnosis
Humans
Male
Middle Aged
Nerve Fibers/*pathology
Optic Disk/*pathology
Optic Neuropathy, Ischemic/*diagnosis
Prospective Studies
Retinal Ganglion Cells/*pathology
Tomography, Optical Coherence
Vision Disorders/*diagnosis
Visual Field Tests
*Visual Fields

Figure

• 

  Fig. 1 The results of visual field test (A-D) and spectral domain optical coherence (E,F). Ischemic optic neuropathy (A,B,E) and open angle glaucoma (C,D,F). RNFL = retinal nerve fiber layer.

• 

  Fig. 2 Retinal nerve fiber layer thickness analysis using spectral domain optical coherence tomography in the unaffected eye. Inferior retinal nerve fiber layer thickness showed a significant difference between the two groups (p < 0.012, Mann-Whitney test). AION = anterior ischemic optic neuropathy. *p < 0.001.

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