OBJECTIVE: To characterize longitudinal optical coherence tomography (OCT) changes in nonarteritic anterior ischemic optic neuropathy (NAION) and evaluate whether early rates of optic nerve head (ONH) swelling are associated with subsequent visual outcomes. DESIGN: Longitudinal cohort study based on a secondary analysis of data from the multicenter randomized QRK207 phase 2/3 NAION trial (NCT02341560). PARTICIPANTS: 715 participants with acute NAION were included. Study eyes were imaged within 14 days of symptom onset. METHODS: ) and logistic regression. MAIN OUTCOME MEASURES: Visual field (VF) total deviation and best-corrected visual acuity (BCVA), with worsening defined as ≥2 dB VF loss or ≥10-letter BCVA loss between Enrollment and Month 6. RESULTS: /day increase in pONHV conferred higher odds of ≥2 dB interval VF worsening (OR, 1.84; 95% CI, 1.3-2.5; P < .001) and ≥10 letter BCVA worsening (OR, 1.52; 95% CI, 1.1-2.1; p < .001) by Month 6. Early reduction in swelling was associated with improved outcomes. Similar associations were observed at Month 2 with larger effect sizes. CONCLUSIONS: Increased ONH swelling rates between Screening and Enrollment were associated with VF and BCVA worsening between Enrollment and Month 6. mGCIPL thinning is detectable within 14 days of NAION symptom onset, preceding overt structural atrophy.
Woods et al. (Fri,) studied this question.