Macular star formation in diabetic patients with non-arteritic anterior ischemic optic neuropathy (NA-AION)

BackgroundNA-AION is a condition that exhibits a number of unique characteristics in diabetics compared with the rest of the population. In some diabetic patients with NA-AION, lipid deposits can be observed around the macula forming an incomplete macular star.MethodsWe describe 12 case studies of patients with NA-AION observing the development of lipid deposits around the macula forming an incomplete macular star.ResultsAll our patients developed some level of lipid deposits around the macula in the form of a macular hemistar in the course of their illness.ConclusionSome authors have suggested that the macular star is formed by transudation from capillaries deep in the optic disk through the intermediary tissue of Kuhnt, which is located between the retina and the anterior portion of the lamina retinalis. However, the development of the macular star is currently understood not as a simple transudation but as a multifactorial process involving the presence of vascular damage around the optic disk, which is considered one of the most important factors leading to its occurrence.Although some studies mention the presence of a macular star in patients with NA-AION, we believe that this phenomenon may be significantly more common than the current literature suggests.