A clinical study on anterior ischaemic optic neuropathy

A prospective observational study was conducted over a period of 12 months on 35 patients presenting with typical features of anterior ischaemic optic neuropathy. Patients with infectious/inflammatory diseases/other disorders that could cause visual defect were excluded from the study. It was found that this disease mostly affects the elderly population with 51-60 years being the most affected age group. Females were found to be more affected than males with the predominance of right eye over left eye. Diabetes mellitus was found to be the most common associated risk factor followed by systemic hypertension. 69.44% of the subjects presented with poor visual acuity in the range of 2/60 to 6/60. Pallid disc oedema was the most common ophthalmoscopic finding followed by sectoral disc pallor. Superior and inferior altitudinal field defects were predominant among patients in whom automated perimetry was possible. In most of the patients, vision remained less than 6/60 despite timely intervention with corticosteroids. The presence of diabetes mellitus is associated with poor visual outcome. But hypertension and hyperlipidemia did not affect the visual outcome. Thus anterior ischaemic optic neuropathy must be considered as an important differential diagnosis of painless loss of vision in elderly population associated with optic disc oedema. All patients must be thoroughly evaluated for systemic risk factors and promptly treated to prevent the condition in the other eye.