Transvitreal optic neurotomy improves visual acuity in recent-onset NAION

Transvitreal optic neurotomy (TON) improves the visual acuity and visual fields in patients with nonarteritic anterior ischemic optic neuropathy (NAION) of recent onset, reported Gholam Peyman, MD, at the American Academy of Ophthalmology annual meeting.

Sixteen patients were included in this masked clinical trial. Eight patients were randomized to undergo TON and eight to observation. The TON procedure included pars plana vitrectomy. An MVR blade was used to cut through the pars plana and the margin of the optic nerve was incised. Patients were examined at 1, 3, 7, and 28 days and then monthly to 6 months postoperatively, Dr. Peyman explained. He is from the Tulane Health Science Center, New Orleans.

The results showed that in the patients who underwent TON, the best-corrected visual acuity was 2.03±0.9 compared with 1.1±0.37 for the control patients. The mean visual acuity improvement was greater in the surgical group than in the controls at 3 (0.8±0.49 compared with 0.24±0.45, respectively; p=0.03) and 6 (1.04±0.83 compared with 0.24±0.45, respectively; p=0.03) months postoperatively. Seventy-five percent of the surgical patients had an increase in visual acuity compared with 25% of controls (p=0.04). The visual fields improved significantly (p=0.01) in 75% of the surgical patients.

"TON may play a role in the treatment of NAION," Dr. Peyman concluded.