Definition
Ischemic optic neuropathy is the most common acute optic neuropathy in adults over the age of 50 years, accounting for many cases of blindness or seriously impaired vision in that age group; however, no age is immune as this disorder has been reported in younger patients as well, including children.
Etiology
A typical classification divides anterior ischemic optic neuropathy into an arteritic (AAION) and non-arteritic (NAION) variants, which has important clinical and prognostic implications. AAION is associated with temporal (giant cell) arteritis and NAION is often related to atherosclerosis.
Clinical Presentation
The typical presentation of both AAION and NAION is painless loss of vision typically associated with optic disk swelling accompanied by flame-shaped (splinter) hemorrhages. However, vision is usually much worse in AAION compared to NAION (light perception vs. 20/200 vision). The visual loss is commonly described as sudden but progression over several days is...
Further Reading
Arnold AC (2003) Pathogenesis of nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol 23(2):157–163
Hayreh SS, Zimmerman MB (2008) Non-arteritic anterior ischemic optic neuropathy: role of systemic corticosteroid therapy. Graefes Arch Clin Exp Ophthalmol 246(7):1029–1046
Lee AG, Brazis PW (1999) Temporal arteritis: a clinical approach. J Am Geriatr Soc
Miller NR, Arnold AC (2014) Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy. Eye (Lond)
Parikh M, Miller NR, Lee AG, Savino PJ, Vacarezza MN, Cornblath W, Eggenberger E, Antonio- Santos A, Golnik K, Kardon R, Wall M (2006) Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis. Ophthalmology 113(10):1842–1845
Scheurer RA, Harrison AR, Lee MS (2012) Treatment of vision loss in giant cell arteritis. Curr Treat Options Neurol 14(1):84–92
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Kesler, A., Dotan, G. (2014). Optic Neuropathy: Ischemic, Arteritic. In: Schmidt-Erfurth, U., Kohnen, T. (eds) Encyclopedia of Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35951-4_1076-1
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DOI: https://doi.org/10.1007/978-3-642-35951-4_1076-1
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Publisher Name: Springer, Berlin, Heidelberg
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