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The Relationship between Low Ocular Perfusion Pressure with Acute Non-Arteritic Anterior Ischemic Optic Neuropathy

Xiaotang Wang, Tao Lei, Yong Wang and Runsheng Wang*

Objective: To investigate the relationship between low ocular Perfusion Pressure (OPP) with Acute Non-Arteritic Anterior Ischemic Optic Neuropathy (ANAION).

Methods: Thirty-nine patients (39 eyes) with ANAION from July 2010 to December 2016 were retrospectively analysed. The 24-h Intraocular Pressure (IOP) in sitting position was measured by non-contact tonometer. The brachial artery Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were simultaneously measured by electrocardiogram monitor. The 24-h OPP was calculated according to the measured blood pressure and IOP: OPP=45% DBP-IOP. OPP<10 mmHg was defined as low OPP. Sudden visual acuity declining or visual field defect was recorded as the attack of ANAION. The correlation between low OPP and ANAION was analysed.

Results: The most common period of low OPP was period A (1-6 A.M). The occurrence of low OPP was higher in period A (17/29, 58.6%). Most common time period of ANAION was also period A (1-6 A.M). The incidence rate of ANAION was higher in period A (21/39, 53.8%). Correlation analysis showed that the period of low OPP was associated with the period of ANAION onset (r=0.61, P=0.002).

Conclusion: There was a significant clinical correlation between low OPP and ANAION. Period A (1-6 A.M) was the high-risk period for low OPP and ANAION. The occurrence of ANAION can be reduced by elevating the OPP to improve the blood perfusion of the anterior optic nerve.