Videofluoreszenzangiographische Untersuchungen bei akuter vorderer ischämischer Opticoneuropathie

Abstract

Acute anterior ischemic optic neuropathy (AION) is a circulatory disorder of the short posterior ciliary arteries and their branches. 74 patients with AION were examined with video fluorescein angiography for disturbance of the retinal circulation. The armretina time (ART) was slightly (15%, p less than 0.01) increased in patients with AION (12.9 +/- 3.9 s) as compared to healthy persons (11.2 +/- 3.3 s). The prolonged ART was more prominent in the 26 (35.1%) diabetic patients (14.2 +/- 3.9 s). Because of the ART being only moderately prolonged and since the Doppler ultrasonography of the carotid arteries showed in only 3 patients an occlusion or a hemodynamically relevant stenosis of greater than or equal to 50%, prolonged ART may play a considerable role in the course of AION in only few patients. The retinal arteriovenous passage time (AVP) is considerably (77%, p less than 0.01) increased in AION (2.57 +/- 0.89 s) as compared to healthy persons (1.45 +/- 0.40 s). In patients with duration of symptoms less than 10 days (2.78 +/- 0.96 s) the AVP was increased (p less than 0.01) as compared to patients with duration of symptoms between 11 and 30 days (2.11 +/- 0.46 s). The comparison between the eye with AION and the not affected eye showed no difference in ART but an increase of AVP in the eye with AION. The AVP in AION patients without and with diabetes was not different. No differences in ART and in AVP were found between arteriitic and non-arteriitic patients with AION. The results indicate that the retinal microcirculation is disturbed in patients with arteriitic and non-arteriitic AION. This condition may worsen the in AION affected microcirculation of the optic nerve head through the mechanism of decreased blood flow in the retinociliary anastomoses.