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Coagulation abnormalities in ischaemic optic neuropathy

J F Acheson1, M D Sanders

  • 1Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, UK.

Eye (London, England)
|January 1, 1994
PubMed
Summary
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This study identifies thrombophilic states as a key factor in non-arteritic ischemic optic neuropathy (ION). Anticoagulation therapy with warfarin may improve visual prognosis for patients with ION and prothrombotic conditions.

Area of Science:

  • Ophthalmology
  • Neurology
  • Hematology

Background:

  • Non-arteritic ischemic optic neuropathy (ION) has a multifactorial etiology involving local and systemic factors.
  • Identifying treatable vascular risk factors is crucial for optimizing visual outcomes and understanding pathogenesis.

Purpose of the Study:

  • To investigate the role of thrombophilic (prothrombotic) states in the etiology of non-arteritic ischemic optic neuropathy (ION).
  • To evaluate the potential benefit of anticoagulation therapy in patients with ION and associated thrombophilia.

Main Methods:

  • Case series describing 7 patients with non-arteritic ischemic optic neuropathy (ION).
  • Assessment of thrombophilic states, including deficiencies in proteins C, S, antithrombin III, anti-phospholipid antibody syndrome, and reduced tissue plasminogen activator (t-PA).

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  • Review of co-existing risk factors for small vessel occlusive disease and recurrence patterns.

    • Main Results:

    • Seven cases of ION associated with thrombophilic states were identified.
    • Included were deficiencies in anticoagulant proteins (Proteins C, S, antithrombin III), anti-phospholipid antibody syndromes, and reduced tissue plasminogen activator (t-PA).
    • Five patients had additional risk factors for small vessel disease, and four experienced recurrent ION episodes.

    Conclusions:

    • Thrombophilic states are an important consideration in the etiology of non-arteritic ischemic optic neuropathy (ION).
    • Anticoagulation with warfarin may offer improved visual prognosis for patients with ION and identified thrombophilic conditions.