Cardiovascular

Evaluation of Peripapillary Vitreous Dynamics in Patients with Acute Nonarteritic Anterior Ischemic Optic Neuropathy.

Orman G, Candan &, et al. • Turkish journal of ophthalmology • 2026

PubMed 42929075 DOI 10.4274/tjo.galenos.2026.62254
TL;DR

Acute NAION is associated with distinct peripapillary vitreoretinal interface characteristics detectable by SD-OCT, but their temporal relationship to ischemic injury remains uncertain.

Key Findings

Results

Peripapillary vitreoretinal adhesion was more frequent in acute NAION eyes than in age- and sex-matched controls.

  • Adhesion was seen in 50% of NAION eyes vs. 25% of controls (p=0.04).
  • The study was a single-center retrospective observational analysis of 60 acute NAION patients and 60 matched healthy controls.
  • Circumpapillary retinal nerve fiber layer scans and macular SD-OCT images were analyzed.
Results

Hyperreflective vitreous dots were much more common and more numerous in NAION eyes than in controls.

  • Prevalence was 68.3% in NAION vs. 8.3% in controls (p<0.001).
  • Mean count was 5.31±6.05 in NAION vs. 0.50±1.54 in controls (p<0.001).
Results

Peripapillary folds were more prevalent in NAION eyes than in controls.

  • Folds were present in 41.7% of NAION eyes vs. 1.7% of controls (p<0.001).
Results

Peripapillary superficial vascular protrusions were common in both groups, but their mean counts differed significantly between groups.

  • The difference in mean counts was reported as p<0.001.
  • The abstract does not give the direction or values of the counts.
Results

Some NAION eyes showed changes in vitreoretinal interface configuration over follow-up.

  • Among 34 NAION eyes with longitudinal follow-up, 29.4% demonstrated interval changes in vitreoretinal interface configuration.
Conclusions

The study assessed a range of peripapillary and vitreomacular interface parameters with SD-OCT, and concluded that acute NAION shows structural differences in vitreoretinal interface configuration, with timing relative to ischemic injury unclear.

  • Parameters included peripapillary vitreoretinal adhesion, vitreoretinal traction, complete peripapillary vitreous detachment, peripapillary folds, superficial vascular protrusions, and hyperreflective vitreous dots; vitreomacular interface characteristics were also evaluated.
  • The authors state that the temporal relationship of these findings to ischemic injury remains uncertain, since the design is retrospective and observational.

What This Means

This study used a detailed eye scan (spectral-domain optical coherence tomography) to look at the area where the gel-like vitreous inside the eye meets the retina near the optic nerve. It compared 60 people with a recent episode of nonarteritic anterior ischemic optic neuropathy (NAION, a sudden loss of blood supply to the optic nerve head) with 60 healthy people of similar age and sex. Eyes with NAION more often showed the vitreous stuck to the retina near the optic nerve (50% vs. 25%), small bright dots in the vitreous (68% vs. 8%), and folds in the tissue around the optic nerve (42% vs. 2%). Among 34 NAION eyes followed over time, about 29% showed changes in how the vitreous and retina were arranged. This research suggests that NAION is linked to specific, visible changes at the vitreous–retina boundary near the optic nerve. However, the study cannot say whether these changes help cause NAION or result from it, because it was retrospective and looked at patients after the event. Further studies would be needed to clarify this.

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Citation

Orman G, Candan &, K&#xfc;&#xe7;&#xfc;kiba K, Sungur G, &#xdc;nl&#xfc; N, Burcu A. (2026). Evaluation of Peripapillary Vitreous Dynamics in Patients with Acute Nonarteritic Anterior Ischemic Optic Neuropathy.. Turkish journal of ophthalmology. https://doi.org/10.4274/tjo.galenos.2026.62254