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Titolo:
Ipsilateral recurrence of nonarteritic anterior ischemic optic neuropathy
Autore:
Hayreh, SS; Podhajsky, PA; Zimmerman, B;
Indirizzi:
Univ Iowa, Coll Med, Dept Ophthalmol, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242 Dept Ophthalmol, Iowa City, IA 52242 USA Univ Iowa, Coll Med, Dept Prevent Med & Environm Hlth, Div Biostat, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242 th, Div Biostat, Iowa City, IA 52242 USA
Titolo Testata:
AMERICAN JOURNAL OF OPHTHALMOLOGY
fascicolo: 5, volume: 132, anno: 2001,
pagine: 734 - 742
SICI:
0002-9394(200111)132:5<734:IRONAI>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
NOCTURNAL ARTERIAL-HYPOTENSION; HIGH INTRAOCULAR-PRESSURE; NERVE HEAD; ATHEROSCLEROTIC MONKEYS; CLINICAL PROFILE; DISORDERS; SLEEP; SEROTONIN; RETINA; YOUNG;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Hayreh, SS Univ Iowa Hosp & Clin, Dept Ophthalmol, 200 Hawkins Dr, Iowa City, IA 52242 USA Univ Iowa Hosp & Clin 200 Hawkins Dr Iowa City IA USA 52242 USA
Citazione:
S.S. Hayreh et al., "Ipsilateral recurrence of nonarteritic anterior ischemic optic neuropathy", AM J OPHTH, 132(5), 2001, pp. 734-742

Abstract

PURPOSE: To report the prevalence of recurrence of nonarteritic anterior ischemic optic neuropathy (NA-AION) in the same eye and possible contributing risk factors. DESIGN: Cohort study. METHODS: Setting: Institutional. STUDY POPULATION: The study includes 594 consecutive patients (829 eyes) with a diagnosis of NA-AION and follow-up of at least two months after the onset of NA-AION, examined in the Ocular Vascular Clinic since 1973. Simple progression of visual loss during an episode of NA-AION was not considered a fresh episode. INTERVENTION OR OBSERVATION PROCEDURES: Every patient had ophthalmic evaluation, including visual acuity, visual fields with a Goldmann perimeter, intraocular pressure, and slit lamp and ophthalmoscopic evaluation at initialvisit and at each follow-up visit. The patients also had systemic evaluation; some patients had echocardiography (166 patients) and 24-hour ambulatory blood pressure (BP) monitoring-the latter was investigated in 80 patients(17 with and 63 without recurrence of NA-AION) who consented to participate in this study which was started in 1989. While optic disk edema was present, the patients were followed every 2 to 3 weeks. Once the optic disk edema resolved, they were followed up after 3 months, 6 months, and then at yearly intervals unless they had some new visual complaint. MAIN OUTCOME MEASURES: Prevalence of a fresh episode of NA-AION in the same eye, and comparison of ocular and systemic risk factors between patients with and without recurrence of NA-AION in the same eye. RESULTS: Of the 594 patients (829 eyes) in the study, recurrence of NA-AION in the same eye occurred in 45 patients (53 eyes) with a median follow-upof 3.1 years (range 2 months to 30.5 years) from the first onset of NA-AION. The Kaplan-Meier survival curve showed cumulative percentage of recurrence of NA-AION from first episode to second episode at three months 1.0% +/-0.4%(SE), at 6 months 2.7% +/- 0.7%, at one year 4.1% +/- 0.9%, and 2 years 5.8% +/- 1.1%. There was no significant association between recurrence ofNA-AION and the systemic conditions that were examined, except for nocturnal arterial hypotension. Overall patients with a recurrence of NA-AION had a significantly lower mean nighttime minimum diastolic BP (P = .003) and greater mean percentage drop during sleep in diastolic BP (P = .011) than those with no recurrence of NA-AION; all other measures of nocturnal hypotension were not significantly predictive. CONCLUSIONS: Recurrence of NA-AION in the same eye is uncommon (6.4%). Ourstudy indicates that nocturnal diastolic arterial hypotension may be a risk factor; however, since this is a multifactorial diseased other so far unknown risk factors may also play a role. The role of various risk factors which may contribute to the recurrence of NA-AION is discussed. (C) 2001 by Elsevier Science Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 03:44:51