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Neuro-ophthalmology and Strabismus

Hayreh SS, Zimmerman MB.

University of Iowa, Iowa City, IA, USA.

 Ophthalmology 2008;115:2275–81.

Editor’s note: In this study, analysis of the refraction of 608 eyes with non-arteritic anterior ischemic optic neuropathy (NAION) showed a statistically significant association between increasing hyperopia and increasing age, but no increase in hypertropia compared with the age-matched population of the Framingham Study and the 1999–2000 National Health and Nutrition Examination Survey. Analysis of the optic disc of the fellow eye in 65 cases revealed a vertical cup/disk (C/D) ratio of <0.25 in 75% and a horizontal C/D ratio of <0.25 in 82%. Comparison with four published population-based studies showed that the C/D ratio in fellow eyes and, thus, in eyes with NAION (because the C/D ratio of the two eyes of any individual is usually the same) is smaller than in the general population. This confirms the generally accepted association between NAION and a small or absent physiological cup, but indicates that this is unrelated to refractive error. The authors argue that the presence of a small or absent physiological cup contributes to the progression of NAION rather being a primary (initiating) factor.

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