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New research · Ophthalmology
Ophthalmology · 1d
Cohort studyOphthalmology · 2026

Early Optic Nerve Head Swelling Rate Is Associated with Worsening of Visual Outcomes in Nonarteritic Anterior Ischemic Optic Neuropathy.

Brian Woods, David Szanto, Jui-Kai Wang … Mark J Kupersmith
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OphthalmologyCohort study

Faster early optic nerve swelling is linked to worse visual field outcomes in nonarteritic anterior ischemic optic neuropathy

Early Optic Nerve Head Swelling Rate Is Associated with Worsening of Visual Outcomes in Nonarteritic Anterior Ischemic Optic Neuropathy.

Brian Woods … Mark J Kupersmith
Ophthalmology · 2026
Purpose

To characterize longitudinal OCT changes in nonarteritic anterior ischemic optic neuropathy (nonarteritic anterior ischemic optic neuropathy) and to evaluate whether early rates of optic nerve head (optic nerve head) swelling are associated with subsequent visual outcomes.

Methods

Seven hundred and fifteen participants with acute nonarteritic anterior ischemic optic neuropathy were imaged within 14 days of symptom onset.

Results

faster swelling in the first days meant higher odds of vision-field worsening later

OR 1.84 (95% CI 1.30 to 2.50)
null 1
1.30
2.50
CI excludes the null - significant
More results

At presentation, study eyes showed pronounced optic nerve head swelling (mean ± standard deviation: RNFLT, 241 ±74.8 μm; ONHV, 6.70 ±1.27 mm 3 ), followed by progressive atrophy (month 6: RNFLT, 56.7 ±14.9 μm; ONHV, 2.7 ±0.41 mm 3 ).

Thinning of the mGCIPL was detectable within 14 days of symptom onset (-0.58 μm/day; P < 0.001).

More results

Early reduction in swelling was associated with improved outcomes.

Similar associations were observed at month 2 with larger effect sizes.

“
Conclusion · 1 of 3

Increased optic nerve head swelling rates between screening and enrollment were associated with visual field and BCVA worsening between enrollment and month 6.

Conclusion · 2 of 3

Thinning of the mGCIPL is detectable within 14 days of nonarteritic anterior ischemic optic neuropathy symptom onset, preceding overt structural atrophy.

Conclusion · 3 of 3

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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