J Korean Ophthalmol Soc.  2019 Sep;60(9):881-886. 10.3341/jkos.2019.60.9.881.

The Function of the Fellow Eye in Patients with Unilateral Nonarteritic Anterior Ischemic Optic Neuropathy

• Baek MS
• Seo YS
• Kyung SE

• KMID: 2459133
• DOI: http://doi.org/10.3341/jkos.2019.60.9.881

Abstract

PURPOSE
To investigate the function of the fellow eye in patients with unilateral nonarteritic anterior ischemic optic neuropathy (NAION).
METHODS
From 2009 to March 2018, 18 patients with NAION who underwent bilateral visual field examinations and follow-up visits at least two times were enrolled in this study. Initial visual acuity, final visual acuity, degree of visual field defects, the cup-disc (C/D) ratio of the fellow eye, and the presence or absence of cardiovascular disease was retrospectively analyzed using medical records.
RESULTS
The fellow eye mean best-corrected visual acuity was 0.03 ± 0.53 (logMAR) and the mean visual field defect was −4.68 ± 3.65 dB in 18 eyes of patients with unilateral NAION (p = 0.007 and p = 0.001, respectively). The C/D ratios were divided into two groups: > 0.3 and < 0.3. The visual field defect was improved significantly from −4.92 dB to −2.37 dB in the group with optic disc ratios < 0.3 (p = 0.013). When the changes in visual field defects were analyzed according to the presence or absence of cardiovascular disease, the visual field defects were improved from −5.65 dB to −4.49 dB in patients with cardiovascular disease, and improved from −3.69 dB to −1.46 dB in patients without cardiovascular disease (p = 0.025 and p = 0.021, respectively).
CONCLUSIONS
In patients with unilateral NAION, reduced function in the fellow eye may appear temporarily, so a visual field examination should be performed in both eyes. The possibility of incipient NAION should be considered in patients with visual field abnormalities in the fellow eye.

Keyword

Incipient Nonarteritic anterior ischemic optic neuropathy; Nonarteritic anterior ischemic optic neuropathy; Visual field

MeSH Terms

Cardiovascular Diseases
Follow-Up Studies
Humans
Medical Records
Optic Neuropathy, Ischemic*
Retrospective Studies
Visual Acuity
Visual Fields

Figure

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  Figure 1 The fundus showed the diffuse optic disc swelling in left eye and small hyperemic optic disc in the right eye of nonarteritic anterior ischemic optic neuropathy (NAION) patient. The fundus of the patient with NAION.

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  Figure 2 The visual field showed visual field defect (left) and improved visual field after 7 months later (right) in the fellow eye of nonarteritic anterior ischemic optic neuropathy (NAION) patient. The visual field of the fellow eye in the patient with NAION. GHT = glaucoma Hemifield test; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

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  Figure 3 Correlation between visual field defect (mean deviation) and C/D ratio in fellow eye of nonarteritic anterior ischemic optic neuropathy. The visual field defect tended to decrease as the cup-to-disc ratio increased. VF = visual field; MD = mean deviation; C/D = cup to disc.

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