Abstract: Objective To observe the characteristics in non-arteritic anterior ischemic optic neuropathy (NA-AION) using optical coherence tomography angiography (OCTA), and investigate the relation with course of disease and visual prognosis. Design Retrospective case series. Participants 24 eyes (24 cases) of NA-AION in Eye Hospital affiliated to Nanjing Medical University from January to June 2019. Methods At the baseline, one month and six months, comprehensive ophthalmologic examinations were performed, including best corrected visual acuity (BCVA) (LogMAR) and OCTA. The characteristics of (BCVA) (LogMAR) and the average retinal nerve fiber layer (RNFL) thickness and the vessel flow density of radial peripapillary capillary (RPC) with different courses of disease were compared, and related factors were analyzed with BCVA (LogMAR) and course of disease. Main Outcome Measures BCVA (LogMAR), RNFL thickness, vessel flow density of RPC. Results Compared with the control group（108.67±3.02 μm）, the RNFL thickness of NA-AION group（315.76±21.45 μm） was significantly thicker, and the vessel flow density of RPC was lower at baseline, the difference were statistically significant (all P<0.05). Compared to the eyes with disease duration≤7 days, there were more significant differences in the vessel flow density of RPC between ischemic and non-ischemic areas in the eyes with disease duration>7 days (P<0.05). The BCVA (LogMAR) was improved at 1 month and 3 months after onset, but there was no significant difference in BCVA (LogMAR) between 1 month and 3 months (P=0.329). Compared with the baseline, the RNFL thickness and the vessel flow density of RPC were decreased gradually at 1 month and 3 months the differences were statistically significant (P<0.05). The BCVA (LogMAR) was significantly positively correlated with RNFL thickness and the vessel flow density of RPC (r= 0.527, 0.550; P<0.05). Conclusion We can observe the change of optic disc RNFL thickness and the vessel flow density of RPC in NA-AION by OCTA, and the visual prognosis is significantly correlated with RNFL thickness and the optic disc vessel flow density. (Ophthalmol CHN, 2021, 30: 425-429)

Key words: non-arteritic anterior ischemic optic neuropathy, optical coherence tomography angiography, course of disease, vision prognosis