Structural and Functional Analyses in Nonarteritic Anterior Ischemic Optic Neuropathy: Optical Coherence Tomography Angiography Study

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Title Structural and Functional Analyses in Nonarteritic Anterior Ischemic Optic Neuropathy: Optical Coherence Tomography Angiography Study
Creator Masayuki Hata, MD; Akio Oishi, MD, PhD; Yuki Muraoka, MD, PhD; Kazuaki Miyamoto, MD, PhD; Kentaro Kawai, MD; Satoshi Yokota, MD; Masahiro Fujimoto, MD; Manabu Miyata, MD, PhD; Nagahisa Yoshimura, MD, PhD
Affiliation Department of Ophthalmology and Visual Sciences, Kyoto University, Kyoto, Japan
Abstract To evaluate the validity of the prevailing concept that Susac syndrome (SS), a rare microvasculopathy of the brain, retina, and inner ear, is a self-limiting disease. We performed a literature search to identify all cases of SS reported between 1973 and October 2015. If available, we determined their demographics, duration of follow-up, and the clinical course that was labeled as monocyclic or polycyclic. We attempted to determine the number of relapses and the relapse rate in patients with polycyclic disease. Our literature search yielded 185 relevant publications reporting 405 cases of SS. The duration of follow-up could be determined in 247/405 cases, with a range 0.5-312 months. The mean was 41 months but the distribution was skewed, with a median of 24 months. Defining the clinical course as monocyclic or polycyclic was possible in 102 patients who were followed for greater than 24 months; 53 were identified as having a polycyclic course. Patients labeled polycyclic were followed longer than those labeled monocyclic (median 62 vs 42 months, P < 0.001). The number or frequency of attacks per patient could not be determined. The follow-up of published cases of SS is short, creating an inherent bias toward the impression that the disease is self-limiting. Our findings suggest that stratification of SS into monocyclic, polycyclic, and chronic continuous courses may oversimplify the phenotype of SS; instead, the possibility of a relapsing-remitting course must be considered in all patients with this disorder.
Subject Aged; Diagnosis, Differential; Female; Fluorescein Angiography / methods; Follow-Up Studies; Fundus Oculi; Humans; Male; Middle Aged; Nerve Fibers / pathology; Optic Disk / pathology; Optic Neuropathy, Ischemic / diagnosis; Optic Neuropathy, Ischemic / physiopathology; Prospective Studies; Retinal Ganglion Cells / pathology; Retinal Vessels / pathology; Tomography, Optical Coherence / methods; Visual Acuity; Visual Fields
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Date 2017-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s65f2zhm
Setname ehsl_novel_jno
ID 1364481
Reference URL https://collections.lib.utah.edu/ark:/87278/s65f2zhm
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