Research Status and Progress of Studies on Optic Disc Structures in Non-arteritic Anterior Ischemic Optic Neuropathy

Non-arteritic anterior ischemic optic neuropathy (NAION) is a prevalent acute optic neuropathy. This article provides a comprehensive overview of the research advancements in regional optic disc structural changes and local risk factors among NAION patients, aiming to establish a foundation for clinical diagnosis, treatment, and future follow-up investigations.

One English database and two Chinese databases were utilized for the purpose of conducting a comprehensive literature search, followed by meticulous analysis. The investigation encompassed an in-depth exploration of the optic disc's structural composition, as well as a thorough examination of the distinctive characteristics exhibited by NAION optic discs. Furthermore, this study aimed to elucidate the intricate relationship between NAION and ODD (Optic Disc Drusen) alongside PHOMS (Peripapillary Hyperreflective Ovoid Mass-like Structures).

A total of 44 English articles were retrieved from Pubmed, including case reports, clinical trials, and reviews. Keywords retrieved included NAION, optic disc, optic disc drusen, PHOMS.

The risk factors of NAION include systemic factors such as hypertension, diabetes, and nocturnal hypotension and local factors such as small optic cup, crowded optic discs, ODD and PHOMS. Among them, ODD and PHOMS are the local anatomical changes of the optic disc, and their relationship with the occurrence of NAION has received more and more attention in recent years. NAION is more likely to occur in eyes with ODD and PHOMS, and NAION patients with ODD and PHOMS have a high prevalence. In recent years, optical coherence tomography (OCT) and optical coherence tomography angiography(OCTA) can provide accurate anatomical imaging and microvascular imaging. Help us better observe the local structural changes and local-related risk factors. Although ODD and PHOMS are closely associated with the occurrence and progression of NAION, research on their relationship is still in its nascent stages. Specifically, further investigation is needed to determine whether the presence of ODD and PHOMS affects the prognosis of NAION patients, including potential influences on lateral eye involvement.This article summarizes the changes in optic disc structure and local risk factors in NAION patients in order to clinical decision making in NIAON patients and provide a basis for further Research on the relationship between the occurrence of NIAON and optic disc structure.