Evaluation of enhanced external counterpulsation therapy for nonarteritic anterior ischemic optic neuropathy

Lixia Lin,Wenhui Zhu,Hui Yang,Xiaofeng Lin,Nan Ma

doi:10.1186/s12886-020-01509-7

Lixia Lin, Wenhui Zhu + Show 3 more

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https://doi.org/10.1186/s12886-020-01509-7

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Journal: BMC ophthalmology	Publication Date: Jun 17, 2020
Citations: 2	License type: open-access

Affiliation: Sun Yat-sen University

Abstract

BackgroundTo explore the effects of enhanced external counterpulsation (EECP) and its underlying influencing factors in nonarteritic anterior ischemic optic neuropathy (NAION) patients.MethodsPatients at Zhongshan Ophthalmic Center with recent-onset (< 8 weeks) NAION were retrospectively recruited. The patients had decided whether or not they would undergo EECP treatment, and the patients who declined were included in the control group. The effectiveness of EECP was evaluated by comparing the visual function and fellow eye involvement in patients with and without EECP treatment.ResultsIn total, 61 patients (76 eyes) were included. Twenty-nine patients (37 eyes) underwent EECP treatment, while 32 patients (39 eyes) were included in the control group. Mean time from NAION onset to EECP initiation was 27.59 ± 16.70 days. In the EECP group, the mean EECP duration was 31.57 ± 18.45 days. EECP was well tolerated by all patients. However, there was no significant difference in visual function between the EECP and control groups. Furthermore, there was no evidence of the effectiveness of EECP in the subgroup analysis of patients with different systemic health conditions. Among the 42 patients with monocular NAION, the sequential attack rate was comparable between the EECP (27.78%) and control (25.00%) groups.ConclusionThis study is the first nonrandomized controlled study to evaluate the effectiveness of EECP in NAION patients. Unfortunately, we failed to demonstrate the effectiveness of EECP in NAION at the 6-month follow-up. Any further application of EECP in NAION patients should be cautious.

Highlights

To explore the effects of enhanced external counterpulsation (EECP) and its underlying influencing factors in nonarteritic anterior ischemic optic neuropathy (NAION) patients
Considering the “ischemic nature” of NAION, we previously investigated the use of EECP in NAION patients, which showed promising short-term results in improvement of visual acuity [8]
One-way analysis of variance (ANOVA) was employed to evaluate the differences between the control group, EECP group with EECP initiated within 2 weeks and EECP group with EECP initiated after 2 weeks

Summary

Introduction

To explore the effects of enhanced external counterpulsation (EECP) and its underlying influencing factors in nonarteritic anterior ischemic optic neuropathy (NAION) patients. Nonarteritic anterior ischemic optic neuropathy (NAION) is an acute vision-threatening neurologic disorder commonly seen in elderly people [1]. The precise pathogenesis of NAION is unclear. NAION risk factors can cause regional hypoxemia-related disc edema, resulting in axon death [3]. Some researchers have suggested that NAION is caused by circulatory insufficiency of the short posterior ciliary arteries, leading to laminar infarction of the optic nerve [4]. The prognosis of NAION is still very poor, the visual acuity improvement is relatively common. No treatment has been shown to be substantially effective for vision function restoration or prevention of fellow eye involvement [5, 6]

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Conclusion