Population-Based Incidence and Outcomes of Compressive Optic Neuropathy

Prior studies on compressive optic neuropathy (CON) have come from large tertiary centers, which may contain referral bias toward more severe or atypical disease. To our knowledge, there are no studies to determine the population-based etiologies and clinical outcomes of compressive optic neuropathy (CON). This study aims to bridge that gap using the Rochester Epidemiology Project database.

Retrospective, population-based cohort.

Medical records of all residents living in Olmsted County, Minnesota, from January 1, 2000, through December 31, 2018, were screened for CON. Demographic and clinical information were collected before and after treatment.

Twenty-three patients had a confirmed diagnosis of CON during our study period, which provided an overall incidence of 1.14 per 100 000 per year. Average age at onset of CON was 51 years (SD 24), and 39% were male. The most common etiologies were pituitary adenoma and meningioma. There was significant improvement in visual fields (P < .003) but not in visual acuity (P = .08) after patients underwent treatment for CON. There was also a significant relationship between the time until treatment and the degree of visual field improvement at follow-up (Pearson correlation rho = -0.58, P < .047).

To our knowledge, this study provides the first population-based incidence of CON. The finding that earlier treatment leads to better visual outcomes stresses the importance of having CON on the differential diagnosis of patients with optic neuropathy.