Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the ischemic optic neuropathy decompression trial

Ischemic Optic Neuropathy Decompression Trial Study Group

Research output: Contribution to journalArticle

173 Citations (Scopus)

Abstract

Objective: To describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT). Design: The IONDT is a single-masked, multicenter, randomized clinical trial. Settings: Twenty-five US clinical centers. Patients: Eligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral non-arteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up. Methods: Each patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements. Results: Of 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95% were white. The mean±SD age at onset was 66.0±8.7 years. Hypertension was reported in 47% of the patients in the IONDT, and 24% of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49% of the patients seeing better than 20/64 and 34% of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9% of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72% were male, and they had a lower prevalence of hypertension and diabetes mellitus. Conclusion: Although our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.

Original languageEnglish (US)
Pages (from-to)1366-1374
Number of pages9
JournalArchives of ophthalmology
Volume114
Issue number11
DOIs
StatePublished - Nov 1 1996
Externally publishedYes

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Ischemic Optic Neuropathy
Decompression
Visual Acuity
Diabetes Mellitus
Patient Acuity
Hypertension
Light
Optic Nerve
Random Allocation
Age of Onset

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the ischemic optic neuropathy decompression trial. / Ischemic Optic Neuropathy Decompression Trial Study Group.

In: Archives of ophthalmology, Vol. 114, No. 11, 01.11.1996, p. 1366-1374.

Research output: Contribution to journalArticle

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title = "Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the ischemic optic neuropathy decompression trial",
abstract = "Objective: To describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT). Design: The IONDT is a single-masked, multicenter, randomized clinical trial. Settings: Twenty-five US clinical centers. Patients: Eligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral non-arteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up. Methods: Each patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements. Results: Of 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95{\%} were white. The mean±SD age at onset was 66.0±8.7 years. Hypertension was reported in 47{\%} of the patients in the IONDT, and 24{\%} of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49{\%} of the patients seeing better than 20/64 and 34{\%} of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9{\%} of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72{\%} were male, and they had a lower prevalence of hypertension and diabetes mellitus. Conclusion: Although our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.",
author = "{Ischemic Optic Neuropathy Decompression Trial Study Group} and Newman, {Nancy J.} and Kay Dickersin and David Kaufman and Shalom Kelman and Roberta Scherer and John Kennerdell and Anna Tyutyunikov and Russell Edwards and Todd Goodglick and Deborah Lang and Kimberly Peele and Sophia Chung and Patty Knaup and Diana Mekelburg and John Holds and John Seihorst and Mark Malton and Sonia Armstrong and Yvonne McCracken and Eugene Benjamin and Evelyn Brooks and Carol Dellinger and Medlin, {Traci Hunter} and Barbara Kmsler and Mike McOwen and Donna Russell and Timothy Saunders and Gregory Kosmorsky and Tina Kiss and Cate Reinhard and Janet Edgerton and Tami Fecko and Susannah Hanson and Brian Kraus and Deborah Ross and Nancy Tomsak and Pamela Vargo and Laura Walsh and Rufus Willis and Steven Feldon and Lori Levin and Kerry Zimmerman and Kristin Anderson and Richard Cortez and Karen Deblanc and Judy H{\~A}¼lse and Richard Morales and Tracy Nichols and Lillian Reyes and John Guy",
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T1 - Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the ischemic optic neuropathy decompression trial

AU - Ischemic Optic Neuropathy Decompression Trial Study Group

AU - Newman, Nancy J.

AU - Dickersin, Kay

AU - Kaufman, David

AU - Kelman, Shalom

AU - Scherer, Roberta

AU - Kennerdell, John

AU - Tyutyunikov, Anna

AU - Edwards, Russell

AU - Goodglick, Todd

AU - Lang, Deborah

AU - Peele, Kimberly

AU - Chung, Sophia

AU - Knaup, Patty

AU - Mekelburg, Diana

AU - Holds, John

AU - Seihorst, John

AU - Malton, Mark

AU - Armstrong, Sonia

AU - McCracken, Yvonne

AU - Benjamin, Eugene

AU - Brooks, Evelyn

AU - Dellinger, Carol

AU - Medlin, Traci Hunter

AU - Kmsler, Barbara

AU - McOwen, Mike

AU - Russell, Donna

AU - Saunders, Timothy

AU - Kosmorsky, Gregory

AU - Kiss, Tina

AU - Reinhard, Cate

AU - Edgerton, Janet

AU - Fecko, Tami

AU - Hanson, Susannah

AU - Kraus, Brian

AU - Ross, Deborah

AU - Tomsak, Nancy

AU - Vargo, Pamela

AU - Walsh, Laura

AU - Willis, Rufus

AU - Feldon, Steven

AU - Levin, Lori

AU - Zimmerman, Kerry

AU - Anderson, Kristin

AU - Cortez, Richard

AU - Deblanc, Karen

AU - Hülse, Judy

AU - Morales, Richard

AU - Nichols, Tracy

AU - Reyes, Lillian

AU - Guy, John

PY - 1996/11/1

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N2 - Objective: To describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT). Design: The IONDT is a single-masked, multicenter, randomized clinical trial. Settings: Twenty-five US clinical centers. Patients: Eligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral non-arteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up. Methods: Each patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements. Results: Of 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95% were white. The mean±SD age at onset was 66.0±8.7 years. Hypertension was reported in 47% of the patients in the IONDT, and 24% of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49% of the patients seeing better than 20/64 and 34% of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9% of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72% were male, and they had a lower prevalence of hypertension and diabetes mellitus. Conclusion: Although our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.

AB - Objective: To describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT). Design: The IONDT is a single-masked, multicenter, randomized clinical trial. Settings: Twenty-five US clinical centers. Patients: Eligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral non-arteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up. Methods: Each patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements. Results: Of 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95% were white. The mean±SD age at onset was 66.0±8.7 years. Hypertension was reported in 47% of the patients in the IONDT, and 24% of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49% of the patients seeing better than 20/64 and 34% of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9% of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72% were male, and they had a lower prevalence of hypertension and diabetes mellitus. Conclusion: Although our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.

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