Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the Ischemic Optic Neuropathy Decompression Trial

OBJECTIVE: To describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT). DESIGN: The IONDT is a single-masked, multicenter, randomized clinical trial. SETTINGS: Twenty-five US clinical centers. PATIENTS: Eligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral nonarteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up. METHODS: Each patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements. RESULTS: Of 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95% were white. The mean +/- SD age at onset was 66.0 +/- 8.7 years. Hypertension was reported in 47% of the patients in the IONDT, and 24% of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49% of the patients seeing better than 20/64 and 34% of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9% of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72% were male, and they had a lower prevalence of hypertension and diabetes mellitus. CONCLUSION: Although our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in Nonarteritic Anterior Ischemic Optic Neuropathy in a Sardinian Population, Italy
Pinna et al.
IOVS 2008;49:1328-1332.
ABSTRACT | FULL TEXT  

The Ischemic Optic Neuropathy Decompression Trial
Newman
Arch Ophthalmol 2007;125:1568-1570.
FULL TEXT  

Non-arteritic anterior ischaemic optic neuropathy and presumed sleep apnoea syndrome screened by the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ)
Li et al.
Br. J. Ophthalmol. 2007;91:1524-1527.
ABSTRACT | FULL TEXT  

Increased relative mitochondrial DNA content in leucocytes of patients with NAION
Abu-Amero and Bosley
Br. J. Ophthalmol. 2006;90:823-825.
ABSTRACT | FULL TEXT  

Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea
Palombi et al.
Br. J. Ophthalmol. 2006;90:879-882.
ABSTRACT | FULL TEXT  

Aggressive Glioma of Adulthood Simulating Ischemic Optic Neuropathy
Danesh-Meyer et al.
Arch Ophthalmol 2005;123:694-700.
FULL TEXT  

Anterior Ischemic Optic Neuropathy in Eyes With Optic Disc Drusen
Purvin et al.
Arch Ophthalmol 2004;122:48-53.
ABSTRACT | FULL TEXT  

Problems With Indexing and Citation of Articles With Group Authorship
Dickersin et al.
JAMA 2002;287:2772-2774.
ABSTRACT | FULL TEXT  

Ischemic Optic Neuropathy Decompression Trial: Twenty-Four-Month Update
Ischemic Optic Neuropathy Decompression Trial Rese
Arch Ophthalmol 2000;118:793-797.
ABSTRACT | FULL TEXT  

Is non-arteritic anterior ischaemic optic neuropathy related to homocysteine?
BIOUSSE et al.
Br. J. Ophthalmol. 2000;84:554c-554.
FULL TEXT  

Morphological variations of the peripapillary circle of Zinn-Haller by flat section
Ko et al.
Br. J. Ophthalmol. 1999;83:862-866.
ABSTRACT | FULL TEXT  

Nonarteritic Anterior Ischemic Optic Neuropathy: Enigma Variations
Lessell
Arch Ophthalmol 1999;117:386-388.
FULL TEXT  

Ischemic Optic Neuropathy Associated With Internal Carotid Artery Dissection
Biousse et al.
Arch Neurol 1998;55:715-719.
ABSTRACT | FULL TEXT