Author reply

Abstract

We thank Drs Lovelace et al for their critical analysis of our recent article. In addition to an obvious mistake, some of their comments are not supported by the general methodology of research. Nowhere in our article have we compared our 3-month data with the 2-year follow-up data of the Ischemic Optic Neuropathy Decompression Trial.1Ischemic Optic Neuropathy Decompression Trial Research GroupIschemic Optic Neuropathy Decompression Trial: twenty-four-month update.Arch Ophthalmol. 2000; 118: 793-797Crossref PubMed Scopus (113) Google Scholar The only comparison we have made is between our 3-month data and the 3-month data of the Ischemic Optic Neuropathy Decompression Trial, whose initial report, quoted in our article, includes only 6 months’ follow-up of their patients.2Ischemic Optic Neuropathy Decompression Trial Research GroupOptic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful.JAMA. 1995; 273: 625-632Crossref PubMed Scopus (294) Google Scholar Lovelace et al have made a comparison between our noncontrolled interventional case series and the nonintervention group of the Ischemic Optic Neuropathy Decompression Trial. We believe such a statistical comparison is not appropriate because the study designs and patient characteristics are hardly comparable. Noncomparative case series, despite their shortcomings, can serve to propose clinical concepts, initially to test efficacy and safety of a procedure and to suggest the need for much larger randomized clinical trials. We reiterate our conclusion that our article describes a pilot study and aims to suggest the possible role of vitreopapillary traction in the pathogenesis of some cases of nonarteritic anterior ischemic optic neuropathy. Anterior Ischemic Optic NeuropathyOphthalmologyVol. 114Issue 12PreviewWe read with great interest the article by Modarres et al.1 However, their study should have the identical disclaimer from the Ischemic Optic Neuropathy Decompression Trial (IONDT) Research Group: “is not effective and may be harmful.”2 We think that Modarres et al inappropriately compared their 3-month data with the 2-year follow-up data, especially when the IONDT Research Group noted that visual acuity declined gradually in both the operative and nonoperative groups after the 3-month visit.3 It would be most appropriate to compare their 3-month outcome data with the original IONDT published 6-month outcome data. Full-Text PDF