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Clinical, biological, and ophthalmological characteristics differentiating arteritic from non-arteritic anterior ischaemic optic neuropathy

Eye volume 37, pages 2095–2100 (2023)Cite this article

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Abstract

Background/Aims

To identify characteristics that can distinguish AAION from NAAION in emergency practice.

Methods

This is a multicentre retrospective case-control study. Ninety-four patients with AAION were compared to ninety-four consecutive patients with NAAION. We compared the clinical, biological, and ophthalmological characteristics at baseline of patients with AAION and those with NAAION.

Results

Patients with AAION were older and more likely to have arterial hypertension. Cephalic symptoms and acute-phase reactants were more frequent in AAION. Profound vision loss and bilateral involvement were more frequent in AAION at baseline. Central retinal and cilioretinal artery occlusions was only observed in AAION, and delayed choroidal perfusion was more frequently observed in AAION than in NAAION. Using logistic regression, an age >70 years (OR = 3.4, IC95% = 0.8–16.1, p = 0.105), absence of splinter haemorrhage (OR = 4.9, IC95% = 1.4–20.5, p = 0.019), delayed choroidal perfusion (OR = 7.2, IC95% = 2.0–28.0, p = 0.003), CRP > 7 mg/L (OR = 43.6, IC95% = 11.6–229.1, p < 0.001) and platelets >400 × G/L (OR = 27.5, IC95% = 4.6–270.9, p = 0.001) were independently associated with a diagnosis of AAION. An easy-to-use score based on these variables accurately distinguished AAION from NAAION with a sensitivity of 93.3% and specificity of 92.4%.

Conclusion

In patients presenting with AION, a set of ophthalmological and laboratory criteria can efficiently discriminate patients with AAION and NAAION and can identify which patients would benefit from high-dose glucocorticoids. External validation of our results is required.

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Authors confirm that the data supporting the findings of this study are available within the article.

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Authors and Affiliations

  1. Department of Internal Medicine, Paris Descartes University, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Paris, France

    Simon Parreau, Alexis Régent & Benjamin Terrier

  2. Department of Internal Medicine, Hôpital Dupuytren, Limoges, France

    Simon Parreau, Stéphanie Dumonteil, Guillaume Gondran, Kim-Heang Ly & Éric Liozon

  3. Department of Ophthalmology, Fondation Adolphe-de-Rothschild hospital, Paris, France

    Alexandre Dentel

  4. Université de Paris, Department of Ophthalmology, Hôpital Cochin, Paris, France

    Rania Mhenni, Dominique Monnet & Antoine P. Brézin

  5. Department of Internal Medicine, Fondation Adolphe-de-Rothschild hospital, Paris, France

    Thomas Sené

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Contributions

Conception and design of the work: SP, TS, BT Acquisition and interpretation of the data: SP, AD, RM, SD, AR, GG, DM, APB, KHL, EL, TS, BT. Drafting the manuscript: SP, BT. Revising the work critically: AD, RM, SD, AR, GG, DM, APB, KHL, EL, TS.

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Correspondence to Simon Parreau.

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Parreau, S., Dentel, A., Mhenni, R. et al. Clinical, biological, and ophthalmological characteristics differentiating arteritic from non-arteritic anterior ischaemic optic neuropathy. Eye 37, 2095–2100 (2023). https://doi.org/10.1038/s41433-022-02295-w

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