Abstract Details

Title Loss of Peripapillary Birefringence at Presentation of Acute NAION Correlates with Baseline and Permanent Regional Visual Field Deficits

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) S47 - (-)

Poster/Presentation
Number 007

Objective

Background Scanning laser polarimetry (SLP), but not optic coherence tomography (OCT), appears to reveal acute injury (loss of birefringence) in non-arteritic anterior ischemic optic neuropathy (NAION) but not with other causes of optic nerve head swelling (AAN 2011).

Design/Methods We prospectively evaluated 25 new NAION eyes with threshold perimetry, SLP and OCT. We compared SLP and OCT average RNFL values, derived from Garway-Heath RNFL mapping of superior and inferior disc RNFL quadrants, with average total deviation (decibels) for corresponding superior and inferior field regions. An SLP or OCT region was considered decreased when the measure was ? 5th percentile of controls.

Results At presentation: 9 eyes had superior quadrant SLP reduced, all of which had inferior field loss that did not recover; 4 eyes had inferior quadrant SLP reduced, 3 of which had superior field loss. In contrast, no eyes had a reduced OCT RNFL until at least 1 month. At presentation, average SLP superior (48[micro]m) and inferior (54[micro]m) quadrants were significantly worse in eyes with loss in corresponding field regions compared with normal eyes (superior 69[micro]m; inferior 73[micro]m). Baseline superior and inferior field thresholds correlated with corresponding (r=0.39) SLP, but not with OCT, quadrant values. Reduced baseline SLP superior and inferior quadrants correlated with 3-6 month regional OCT thinning (r=0.49) and field loss (r=0.64).

Conclusions The SLP measured RNFL is frequently reduced in the regions corresponding to visual field loss at presentation in eyes with NAION. Since the visual fields show no notable recovery, SLP loss of birefringence seems to be an early marker for axonal injury and permanent deficits.

Authors/Disclosures
Mark J. Kupersmith, MD, FAAN (Icahn School of Medicine At Mount Sinai) PRESENTER	Dr. Kupersmith has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal firms. Dr. Kupersmith has stock in SafeTherapeutics m,LLC. The institution of Dr. Kupersmith has received research support from NEI, NYEEI FDN, Shulman Family NAION fund. Dr. Kupersmith has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Davorka Tomic	Davorka Tomic has stock in Meck KGaA.

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