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Purpose : To estimate the incidence of arteritic anterior ischemic optic neuropathy (AAION) associated with giant-cell arteritis (GCA) among the patients with AION in Korea, and investigate distinctive clinical features of AAION in the Korean patients based on our case-series and reported cases in the literature.
Methods : Medical records of the patients who had diagnosed as anterior ischemic optic neuropathy from January 2013 to August 2018. The patients were divided into 2 groups: AAION associated with GCA and non-arteritic ischemic optic neuropathy (NAION). In addition, we reviewed the literature and identified all cases with AAION in Korean patients. We evaluated clinical data including initial and final best-corrected visual acuity, fundus photographs, visual field testing, fluorescein angiography and contrast-enhanced magnetic resonance imaging, and compared with Caucasian patients in the literature.
Results : Of the 142 patients, three (2.1%) were diagnosed as AAION and 139 (97.9%) were diagnosed as NAION. Seven patients with AAION associated with GCA in Korean patient were identified from our data and literature review. We found no difference in ay clinical features except for laterality, four among seven patients had bilateral involvement. Moreover, optic nerve sheath enhancement was observed in two patients in our Korean cohort.
Conclusion : AAION associated with GCA is very rare condition compared to NAION in Korea, however, GCA should be considered in every single case of ischemic optic neuropathy patients because AAION had poor visual outcome, sometimes bilaterally. Additionally, GCA can be presented with optic perineuritis, suspicion of GCA should be included during optic perineuritis work-up.
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