Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Feb 26;19(5):2718.
doi: 10.3390/ijerph19052718.

Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis

Krisztina Lantos  1 , Zsuzsa Réka Dömötör  2 , Nelli Farkas  3 , Szabolcs Kiss  4   5 , Zsolt Szakács  5 , András Garami  5 , Gábor Varga  6 , László Lujber  7 , Reem Kanaan  8 , Péter Hegyi  5 , Gergely Fehér  9 , Valéria Gaál  1
Affiliations
Meta-Analysis

Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis

Krisztina Lantos et al. Int J Environ Res Public Health. .

Abstract

Background: Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is the second most common cause of optic nerve-related permanent visual loss in adults.

Aim: We aimed to analyze the efficacy of the noninvasive and minimally invasive therapeutic options of NAION.

Methods: We performed a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to 10 June 2019 to identify the studies that report on the effect of different therapies on visual acuity (VA) and visual field (VF). Weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for these outcomes. The efficacy of steroids was investigated in quantitative, oxygen, steroid plus erythropoietin (EPO), levodopa/carbidopa, memantine, and heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) therapies and other therapeutic modalities in qualitative synthesis.

Results: Thirty-two studies were found to be eligible. We found that steroid therapy compared to control did not improve VA (p = 0.182, WMD = 0.14, 95% CI: -0.07, 0.35) or VF (p = 0.853, WMD = 0.16, 95% CI: -1.54, 1.86). Qualitative analysis could be performed for oxygen, steroid plus EPO, and HELP as well, however, none of them showed VA and VF benefit. Two individual studies found memantine and levodopa beneficial regarding VA.

Conclusion: Our systematic review did not reveal any effective treatment. Further investigations are needed to find therapy for NAION.

Keywords: NAION; meta-analysis; nonarteritic ischemic optic neuropathy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flowchart.
Figure 2
Figure 2
Comparison of interventions to no treatment regarding visual acuity (as a continuous variable).
Figure 3
Figure 3
Comparison of interventions to no treatment regarding visual acuity (as a categorical variable).
Figure 4
Figure 4
Comparison of interventions to no treatment regarding visual field.
See this image and copyright information in PMC

References

    1. Pakravan M., Sanjari N., Esfandiari H., Pakravan P., Yaseri M. The effect of high-dose steroids, and normobaric oxygen therapy, on recent onset non-arteritic anterior ischemic optic neuropathy: A randomized clinical trial. Graefe’s Arch. Clin. Exp. Ophthalmol. 2016;254:2043–2048. doi: 10.1007/s00417-016-3451-6. - DOI - PubMed
    1. Judit Somlai T.K.E. Neuro-Ophthalmology, Vascular Diseases of the Optic Nerve: The Neuro-Ophthalmologist’s Approach. Springer International Publishing; Cham, Switzerland: 2016. p. 395.
    1. Atkins E.J., Bruce B., Newman N.J., Biousse V. Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy. Surv. Ophthalmol. 2010;55:47–63. doi: 10.1016/j.survophthal.2009.06.008. - DOI - PMC - PubMed
    1. Rebolleda G., Pérez-López M., Casas-Llera P., Contreras I., Muñoz-Negrete F.J. Visual and anatomical outcomes of non-arteritic anterior ischemic optic neuropathy with high-dose systemic corticosteroids. Graefe’s Arch. Clin. Exp. Ophthalmol. 2013;251:255–260. doi: 10.1007/s00417-012-1995-7. - DOI - PubMed
    1. Pakravan M., Esfandiari H., Hassanpour K., Razavi S., Pakravan P. The Effect of Combined Systemic Erythropoietin and Steroid on Non-arteritic Anterior Ischemic Optic Neuropathy: A Prospective Study. Curr. Eye Res. 2017;42:1079–1084. doi: 10.1080/02713683.2016.1270328. - DOI - PubMed

Publication types