AIM:To investigate the clinical profiles, visual outcomes and related factors for the patients with nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS: From January 2006 to December 2009 in our hospital, 116 consecutive patients(116 eyes)with NAION were retrospectively analyzed. The clinical and fundus fluoresecein angiographic profiles, visual outcomes and related factors of the patients were recorded. The routine managements included controlling systemic diseases, systemic vasodilators, neuroprotection agents or oral corticosteroids.

RESULTS: Of 116 cases, 65 were males and 51 were females. The average ages were 56.4±9.8 years. The unilateral onset were 98 cases(84.5%)and the bilateral onset were 18 cases(15.5%). The papillary edemas were seen in all patients and the peripapillary hemorrhages were seen in some patients. The visual field defects were seen in all patients, and the inferior altitudinal defects or nasal inferior defects were common(53.7%). The filling defect or delay was seen in all patients at the early stage of fluorescein fundus angiography and the optic disc staining or diffuse fluorescein leakage at the late stage. After the active treatment for 2-3 months, the papillary edemas were subsided, and the optic nerve were sectoral or diffuse atrophy. The visual fields defects of 87.3% eyes were improved or stable, and 12.7% eyes were residual partial visual defect. The average best-corrected vision of 116 eyes at the initial visit were 0.52±0.21, and the corrected vision at the final visit were 0.68±0.20, the vision were improved after the treatment(t=10.61, P=0.000). Among the 116 patients, 72 cases(62.1%)were with cardiovascular disorders, 52 cases(44.8%)with systemic hypertension and 27 cases(23.3%)with diabetes mellitus. After the logistic regression analysis, the related factors for the lower final visual acuity(0.5 or less)were related to the lower initial vision(0.5 or less), diabetes mellitus history and older ages(over 60 years), there were not related to the gender and systemic hypertension.

CONCLUSION: Elderly persons with systemic hypertension or diabetes mellitus were the major risk factors for the pathogenesis of NAION and poor visual prognosis. Corrected diagnosis and proper treatment would improve the optic nerve ischemia, and improve the visual acuity and visual field defects recovery.