Abstract
Purpose: To evaluate the effect of intravitreal injection of Bevacizumab on improving visual function in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION). Methods: In a prospective interventional case series, 11 eyes with vision loss due to (NAION) in less than 15 days of attack were studied. Visual acuity, perimetry and optic nerve head changes were evaluated 1 week post-intravitreal injection of 1.25mg/0.1 mL Bevacizumab. Results: 5 of patients had improved visual acuity. In all patients optic disc edema resolved either completely or remarkably in 1 week, but there was no significant change in perimetric values. Conclusion: This case series suggest that intravitreal injection of Bevacizumab may be beneficial in treatment of NAION. Keywords : Intravitreal Bevacizumab; Non-arteritic anterior ischemic optic neuropathy; Perimetry
Highlights
Non-arteritic anterior ischemic optic neuropathy (NAION) is a disease caused by ischemia of optic nerve which leads to optic nerve swelling and acute painless vision loss [1]
intravitreal Bevacizumab (IVB) was used in a patient with visual loss due to NAION after 3 weeks of attack
This improvement of visual acuity and optic disc edema with significant resolution of leakage suggests that increased vascular permeability due to vascular endothelial growth factor (VEGF) may play an important role in NAION [7]
Summary
Non-arteritic anterior ischemic optic neuropathy (NAION) is a disease caused by ischemia of optic nerve which leads to optic nerve swelling and acute painless vision loss [1]. It is probably due to inefficient blood supply by short posterior cilliary arteries and usually affects patients with small optic nerve cupping [3,4,5,6]. Ischemia causes release of vascular endothelial growth factor (VEGF) which in turn increases vascular permeability and leads to vasogenic edema [7]. Induced edema in the setting of crowded disc leads to a compartment like syndrome in optic nerve head [1,8,9] that reduces blood supply to unaffected segments of optic nerve [5]. A patient had improved vision after intravitreal Bevacizumab (IVB) injection [7].
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