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Diagnosis and management of three optic neuropathies: a national survey

Graefe's Archive for Clinical and Experimental Ophthalmology volume 258, pages 1975–1981 (2020)Cite this article

Abstract

Background

We aimed to evaluate the current practice patterns of neuro-ophthalmologists in diagnosis and management of three optic neuropathies using a national survey in South Korea and to further compare the practices of neuro-ophthalmologists divided into junior and senior groups based on their clinical practice experience.

Methods

An anonymous, 15-question survey on the diagnosis and treatment of traumatic optic neuropathy (TON), nonarteritic anterior ischemic optic neuropathy (NAION), and Leber’s hereditary optic neuropathy (LHON) was sent to all neuro-ophthalmologists registered with the Korean Neuro-ophthalmology Society. The questions addressed physician’s practice duration as neuro-ophthalmologist, choices of MRI scans and laboratory tests for the diagnosis in suspected optic neuropathy, clinical experiences with steroids (e.g., side effects), and choices of treatment modalities and reason in in each optic neuropathy. All participants were classified into senior (≥ 10 years) and junior (< 10 years) groups.

Results

A total of 63 responders (response rate 78.8%) answered the questionnaire. All responders performed the basic blood tests and brain imaging for evaluating optic neuropathy. Observation was the most preferred option for TON (47.6%) and NAION (63.5%). Steroid use was the second most preferred, and the most selected indication of steroid was “when the patient wants” (58.7%) for TON and “severe visual loss or last eye” (66%) for NAION. The most preferred treatment for LHON was “prescribing idebenone” (69.7%) with a dose of 900 mg/day (63.8%). Forty-nine respondents (77.8%) experienced side effects of steroids. There was no significant difference between the senior and junior groups in all questionnaire answers (all p > 0.05).

Conclusion

Optic neuropathies are being managed similarly by the two groups in South Korea, and many of them still use steroids. We provided reliable reasons for our results compared with other countries.

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Author information

Author notes

  1. Haeng-Jin Lee and Hyuna Kim contributed equally to this work.

Affiliations

  1. Department of Ophthalmology, Jeonbuk National University Hospital, Jeonju, South Korea

    Haeng-Jin Lee

  2. Department of Ophthalmology, Gyeongsang National University Hospital, Jinju, South Korea

    Hyuna Kim

  3. Department of Ophthalmology, Myongji hospital, College of Medicine, Hanyang University, Goyang, South Korea

    Ju-Yeun Lee

Authors
  1. Haeng-Jin Lee
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  2. Hyuna Kim
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  3. Ju-Yeun Lee
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Contributions

H.L, H.K, and J.L designed and conducted the study, analyzed and interpreted the data, drafted the manuscript, and approved the final version of the manuscript. This paper was presented at the 121st meeting of Korean Ophthalmology Society (April 2019).

Corresponding author

Correspondence to Ju-Yeun Lee.

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The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. This study was approved by the Institutional Review Board of Myongji Hospital and followed the tenets of the Declaration of Helsinki.

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This type of study does not require informed consent due to retrospective data collection.

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Lee, HJ., Kim, H. & Lee, JY. Diagnosis and management of three optic neuropathies: a national survey. Graefes Arch Clin Exp Ophthalmol 258, 1975–1981 (2020). https://doi.org/10.1007/s00417-020-04711-x

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  • DOI: https://doi.org/10.1007/s00417-020-04711-x

Keywords

  • Nonarteritic anterior ischemic optic neuropathy
  • Traumatic optic neuropathy
  • Neuro-ophthalmology
  • Survey
  • Leber’s hereditary optic neuropathy