Intravitreal ranibizumab injection for nonarteritic ischemic optic neuropathy.
OBJECTIVE
The aim of this study was to evaluate the functional and morphological outcomes of intravitreal ranibizumab injection (IVR) in the treatment of nonarteritic ischemic optic neuropathy (NAION).


METHODS
Three patients with NAION of 1–2 days onset underwent IVR. A complete ophthalmologic examination was performed at baseline (before IVR) and at 1 day, 1 week, 1 month, 6 months, and 1 year following IVR.


RESULTS
In all patients, we found an early resolution of optic disk swelling, as soon as 1 week after IVR; however, such a morphological improvement was not accompanied by a corresponding functional (visual acuity and perimetric) improvement. The first treated patient presented a good visual acuity and a relative central visual field defect at baseline, and at the 12-month follow-up, we found an overall functional stabilization, with no further visual acuity and visual field deterioration. The second and third treated patients presented a lower visual acuity and an absolute center-involving visual field defect at baseline. In these patients, despite early papillary edema resolution, late optic nerve atrophy occurred, and visual acuity and visual field did not improve at the 12-month follow-up.


CONCLUSIONS
The results from our study suggest that even if IVR is effective in reducing optic nerve swelling in NAION patients, no functional improvement may be observed. Further studies are necessary to definitively establish the efficacy and safety of IVR in the treatment of NAION.
Pece
Alfredo
A
Department of Ophthalmology, Melegnano Hospital , Milan, Italy. pece.retina@mclink.it
Querques
Giuseppe
G
Quinto
Alessandra
A
Isola
Vincenzo
V
D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001167:Arteritis / Q000188:drug therapy; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000188:drug therapy* / Q000503:physiopathology; D010211:Papilledema / Q000188:drug therapy / Q000503:physiopathology; D000069579:Ranibizumab; D016896:Treatment Outcome; D014792:Visual Acuity; D014794:Visual Fields
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab