Restoring visual function in NAION by means of transpalpebral electrical stimulation: A case report

IntroductionNon-arteritic anterior ischemic optic neuropathy (NAION) is a major cause of vision loss in middle-aged and elderly populations, with no effective treatment currently available. Electrical stimulation (ES) has shown potential in preserving and restoring neural function in optic neuropathies. This study investigates the efficacy of transpalpebral ES in improving visual function in a patient with long-term visual impairment due to NAION.MethodsA 62-year-old male patient with sequential NAION in both eyes underwent a 60-day transpalpebral ES for 20 min daily. Visual function was assessed at baseline and after 30 and 60 days of treatment, including best-corrected visual acuity (BCVA), contrast sensitivity, visual field (VF) analysis, and microperimetry.ResultsSignificant improvements in BCVA were detected, with an overall increase of 11 ETDRS letters in the right eye and 18 in the left eye after 60 days of treatment. Contrast sensitivity also improved in both eyes. Visual field parameters, including mean deviation, pattern standard deviation and visual field index, showed notable enhancements. Microperimetry revealed increased macular sensitivity and improved fixation stability. The patient also reported subjective improvements. No adverse events were noted.DiscussionES has been shown to enhance retinal function by modulating neuronal excitability, activating neuroprotective signaling pathways, and potentially supporting neural regeneration. In our case, transpalpebral ES was associated with meaningful improvements in visual function in a patient with long-term NAION-related visual impairment. These results suggest ES as a promising approach for NAION, though further research is needed to confirm these results and optimize treatment protocols.