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Cohort studyJournal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2026

Quantification of Mitochondrial Stress in Nonarteritic Anterior Ischemic Optic Neuropathy Using Flavoprotein Fluorescence Imaging.

Rishita Rama Pujari, Yulan Ren, Jamie Zhang … Yaping Joyce Liao

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OphthalmologyCohort study

Optic disc mitochondrial stress signal rises in months after optic nerve stroke

Quantification of Mitochondrial Stress in Nonarteritic Anterior Ischemic Optic Neuropathy Using Flavoprotein Fluorescence Imaging.

Rishita Rama Pujari … Yaping Joyce Liao

Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2026

Background

Nonarteritic anterior ischemic optic neuropathy (nonarteritic anterior ischemic optic neuropathy) or optic nerve stroke is the most common acute optic neuropathy in patients older than 50 years and results in severe vision loss.

Purpose

We investigated the evolution of optic disc and macular flavoprotein fluorescence, and other ophthalmic measurements in the first 6 months after nonarteritic anterior ischemic optic neuropathy onset.

Methods

We retrospectively analyzed 10 patients (15 eyes) with acute nonarteritic anterior ischemic optic neuropathy and performed serial assessments of visual function, optic disc flavoprotein fluorescence, macular flavoprotein fluorescence, and spectral-domain optical coherence tomography for 6 months.

n = 15 eyes

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Results

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optic disc mitochondrial stress marker rose, signaling higher metabolic strain over time

n = 15 eyes

More results

In the acute phase (<45 days), RNFL thickness was elevated, consistent with optic disc edema, while optic disc flavoprotein fluorescence values were within the normal range.

Over time, optic disc flavoprotein fluorescence increased, and RNFL thickness decreased, with relative stabilization after approximately 3 months, whereas visual acuity remained stable.

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Conclusion · 1 of 2

Optic disc flavoprotein fluorescence is normal in acute nonarteritic anterior ischemic optic neuropathy because of masking by optic disc edema.

Conclusion · 2 of 2

As optic disc edema resolves, optic disc flavoprotein fluorescence score increases, reaching a plateau at around 3 months after onset, consistent with increased axonal metabolic stress.

Post

Quantification of Mitochondrial Stress in Nonarteritic Anterior Ischemic Optic Neuropathy Using Flavoprotein Fluorescence Imaging.

Optic disc mitochondrial stress signal rises in months after optic nerve stroke

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