Early Optic Nerve Head Swelling Rate Predicts Visual Outcome Deterioration in Nonarteritic Anterior Ischemic Optic Neuropathy: An Evidence-Based Review

Highlights

• Rapid early optic nerve head swelling, quantified by peripapillary optic nerve head volume increase, strongly predicts visual field and acuity worsening in acute NAION.
• Macular ganglion cell-inner plexiform layer thinning is detectable within two weeks of symptom onset, preceding overt structural optic nerve atrophy.
• Optical coherence tomography angiography demonstrates a sequential decline in peripapillary and macular vascular densities paralleling structural damage progression in NAION.
• Combined OCT and scanning laser polarimetry modalities reveal distinct yet complementary insights on axonal integrity during acute NAION-induced optic nerve head swelling.