DOI: https://doi.org/10.36347/sjams.2024.v12i10.002

Pages: 1262-1270

Background: Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is the second leading cause of permanent optic nerve-related vision loss in adults. Aim: This study aimed to evaluate the effectiveness of noninvasive and minimally invasive treatments for AION. Methods: A systematic literature review was conducted using MEDLINE, EMBASE, and CENTRAL databases from their inception until June 10, 2019, to identify studies reporting the impact of various therapies on visual acuity (VA) and visual field (VF). The weighted mean difference (WMD) with a 95% confidence interval (CI) was calculated for these outcomes. The efficacy of steroids was quantitatively assessed, alongside qualitative evaluations of treatments such as oxygen therapy, steroid plus erythropoietin (EPO), levodopa/carbidopa, memantine, and heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP). Results: Thirty-two studies were deemed eligible for inclusion. Steroid therapy showed no significant improvement in VA (p = 0.182, WMD = 0.14, 95% CI: −0.07, 0.35) or VF (p = 0.853, WMD = 0.16, 95% CI: −1.54, 1.86) compared to controls. Qualitative analyses of oxygen therapy, steroid plus EPO, and HELP also showed no significant benefits for VA or VF. However, two studies reported that memantine and levodopa had positive effects on VA. Conclusion: Our systematic review found no consistently effective treatments for AION, highlighting the need for further research into potential therapies.