High-sensitivity C-reactive protein measurements in patients with non-arteritic anterior ischaemic optic neuropathy: a clue to the presence of a microinflammatory response.

PURPOSE: To explore the possibility that individuals with non-arteritic anterior ischaemic optic neuropathy (NA-AION) harbour a heightened microinflammatory response compared to carefully matched controls.

METHODS: Diagnosis and follow-up were performed by a senior neuro-ophthalmologist (A.K.). The inflammatory biomarkers included white blood cell count, Westergren erythrocyte sedimentation rate (ESR), quantitative fibrinogen as well as high-sensitivity C-reactive protein (hs-CRP). The values of the inflammatory biomarkers of four and five matched controls were compared to patients with NA-AION.

RESULTS: We examined 33 NA-AION patients and 151 controls matched for age, gender, body mass index, oral temperature, smoking status and atherothrombotic risk factors. A significantly elevated concentration was noted for hs-CRP (P = 0.021): 3.3 mg/l for NA-AION patients and 2.1 mg/l for controls. Accelerated ESR (18.8 versus 13.5 mm/hr, P = 0.025) was noted in the NA-AION patients.

CONCLUSION: Following appropriate matching to apparently healthy controls, patients with NA-AION presented a microinflammatory response, revealed by the presence of increased hs-CRP concentrations and accelerated ESR. The finding, if confirmed in future studies, might shed more light on the eventual pathophysiological processes involved in the disease and pave the way for new therapeutic approaches.