TO STUDY THE EFFECT OF INTRAVITREAL TRIAMCINOLONE ACETONIDE IN CASES OF NON ARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY.

Abstract

Purpose: To study the effect of intravitreal Triamcinolone Acetonide in cases of Non Arteritic Anterior Ischemic Optic Neuropathy (NAION).

Method: Prospective interventional study included fifteen patients with unilateral acute NAION who received 2 mg of intravitreal triamcinolone acetonide and were followed up for 12 weeks.

Result: Disc edema was replaced by pallor within six weeks. Visual Acuity improved from log MAR 1.48 to log MAR 0.97 at 12 weeks along with significant improvement in latency and amplitude of pattern visual evoked potentials. Visual fields, colour vision, contrast sensitivity showed incomplete recovery. Pattern Electroretinogram showed reduction of N95 amplitude (4.183 to 3.377uV) along Retinal nerve fiber layer loss (RNFL)   (135.13 to 64.8 um).Visual acuity at 12 weeks showed significant correlation only to the amplitude of pattern electroretinogram.

Conclusion: Since acute NAION is associated with significant ganglion cell loss. Study  recommend complete evaluation for visual function in all cases of  NAION in affected and unaffected eye which includes, visual acuity, colour vision, contrast senstivity, visual fields, electrophysiology and Optical Coherence tomography  RNFL, Ganglion cell complex and Macular volume. It signifies the use of these parameters in neuroprotective trials to monitor the efficacy of therapies aimed at nerve protection. It also emphasise the role of IVTA in treatment of acute NAION presenting as early as 2 weeks.

Keywords: NAION, Pattern ERG, Triamcinolone Acetonide, Intravitreal