Vitreopapillary interface features in patients with non-arteritic anterior ischemic optic neuropathy

PURPOSE: The objective of this study was to evaluate the vitreopapillary interface features in patients with acute and non-acute non-arteritic anterior ischemic optic neuropathy (NAION) compared with healthy controls.
METHODS: This is a retrospective cohort study and included 30 affected eyes (group 1) and 30 unaffected fellow eyes (group 2) from 30 NAION patients and 30 eyes from 30 age- and sex-matched healthy controls (group 3). Posterior vitreous detachment (PVD), peripapillary wrinkles (PPWs), and peripapillary superficial vessel protrusion (PSVP) at the vitreous-peripapillary interface were assessed from optical coherence tomography slices.
RESULTS: The average age of the patients was 60.7±10.7 years, and the average age of the controls was 57.4±9.5 years (p=0.213). The prevalence of complete PVD at the time of acute presentation was 23.3% in group 1, 0.0% in group 2, and 16.7% in group 3 (p=0.004). At the 3rd month, the prevalence of complete PVD increased to 30% in group 1 and remained unchanged in group 2. The number of PPWs was 5.33±2.96, 3.57±1.43, and 1.37±0.76 in groups 1, 2, and 3, respectively (p<0.001) at baseline. At the 3rd month, the PPW in group 1 was significantly greater than that in group 2 (p=0.011). The number of PSVPs was 8.4±3.47 in group 1, 10.7±1.82 in group 2, and 7.43±1.28 in group 3 at baseline (p<0.001). There was no significant difference in the number of PSVPs among the groups at the end of 3-month follow-up (p=0.96).
CONCLUSION: PVD was present in almost one-third of eyes that had suffered NAION, and the affected eyes had PVD significantly more frequently than the unaffected eyes. The increased PPW in the affected eyes of NAION patients may be related to optic nerve head edema. NAION patients had more superficial vessel protrusion in the subacute period regardless of ischemic episode.

Keywords: Non-arteritic anterior ischemic optic neuropathy, Papillary vitreous detachment, Peripapillary superficial vessel protrusion, Peripapillary wrinkles, Vitreopapillary traction.