Non-arteritic anterior ischemic optic neuropathy: long-term results after hemodilution therapy

Abstract

In patients with nonarteritic anterior ischemic optic neuropathy (AION) we investigated the long-term effect of hemodilution on functional results, recurrence rate in the affected and involvement of the second eye. In a retrospective study we reviewed 24 patients ranging in age from 62 to 92 years (mean 77 years) with AION. The duration of follow-up was between 8-51 months (mean 24.8 months). All patients received iso- (Hct > 40%) or hypervolemic (Hct < or = 40%) hemodilution over 8-10 days with daily infusion of 10% hydroxyethyl-starch 200/0.5. The hematocrit decreased significant (p < 0.001) from 43.4 +/- 3.8% to 37.8 +/- 3.5% after this 10-day hemodilution treatment. After the longterm follow-up 29.1% of the patients had an improvement of the central vision by two or more lines, 16.7% had a deterioration, 54.2% remained unchanged. The resulting visual acuity was between 0.5-1.0 in 37.5%, between 0.4-0.1 in 41.7% and worse than 0.1 in 20.8%. Neither visual fields nor the VECP were significant changed by hemodilution. After the mean follow-up period of 24.8 months no recurrence occurred in the affected eye and the second eye as never involved. Hemodilution therapy has no significant longterm effect on visual acuity and visual fields, but it seems to have a beneficial influence on the recurrence rate in the affected and on the involvement of the second eye.