AIM: To explore the therapeutic effects and safety of dexamethasone intravitreal implant(DEX)on non-arteritic anterior ischemic optic neuropathy(NAION), and responses to the different course of disease.

METHODS: Totally 70 patients(70 eyes)in the First Affiliated Hospital of Zhengzhou University diagnosed with NAION from January 2018 to December 2020 were obtained retrospectively as combination treatment group and routine treatment group. 35 patients(35 eyes)in each group received usual care(methylprednisolne pluse therapy, microcirculation improvement and neurotrophic treatment), and combination treatment group also received a dexamethasone intravitreal implant. The best corrected visual acuity(BCVA), mean damage(MD)and pattern standard deviation(PSD)of the visual field, mean thickness of the retinal nerve fiber layer(RNFL)and intraocular pressure(IOP)were compared between the two groups, and two groups with a different course of disease before and 3mo after treatment.

RESULTS: BCVA and MD improved in both groups at 3mo after treatment(P<0.05). The PSD in the combination treatment group was not significantly different before and after treatment(P>0.05). The PSD at 3mo after treatment in the routine treatment group was worse than before treatment(P<0.05). BCVA, MD, and PSD in the combination treatment group had better improvement than in the routine treatment group at 3mo after treatment(P<0.05). Visual acuity improvement rate in the combination treatment group was higher than in the routine treatment group at 3mo after treatment(P<0.05). There was no obvious difference in RNFL thickness between the two groups(P>0.05). BCVA, PSD and effective rate in the combination treatment group had better improvement than in the routine treatment group in disease course ≤ 15d at 3mo after treatment(P<0.05), and no apparent difference in the group of disease course > 15d(P>0.05). There was a mild and controllable increase in IOP in the combination treatment group compared to routine treatment group.

CONCLUSION: Dexamethasone intravitreal implant can promote BCVA and the recovery of visual function for the long term. It is deemed safe and effective in treating NAION, with better therapeutic effects within 2wk after onset.