Ischemic optic neuropathy

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Ischemic optic neuropathy
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Ischemic optic neuropathy (ION) is the loss of structure and function of a portion of the optic nerve due to obstruction of blood flow to the nerve (i.e. ischemia). Ischemic forms of optic neuropathy are typically classified as either anterior ischemic optic neuropathy or posterior ischemic optic neuropathy according to the part of the optic nerve that is affected. People affected will often complain of a loss of visual acuity and a visual field, the latter of which is usually in the superior or inferior field. [1]

Contents

When ION occurs in patients below the age of 50 years old, other causes should be considered, such as juvenile diabetes mellitus, antiphospholipid antibody-associated clotting disorders, collagen-vascular disease, and migraines. Rarely, complications of intraocular surgery or acute blood loss may cause an ischemic event in the optic nerve. [2]

Presentation

Anterior ION presents with sudden, painless visual loss, developing over hours to days. [3]

Diagnosis

Examination findings usually include decreased visual acuity, a visual field defect, color vision loss, a relative afferent pupillary defect, and a swollen optic nerve head. Posterior ION occurs arteritic, nonarteritic, and surgical settings. It is characterized by acute vision loss without initial disc edema, but with subsequent optic disc atrophy. [3]

Management

Although there is no recognized treatment that can reverse the visual loss, upon recent reports, optic nerve health decompression may be beneficial for a select group of patients with a gradual decline in vision due to ION. [4]

See also

Related Research Articles

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Anterior ischemic optic neuropathy (AION) is a medical condition involving loss of vision caused by damage to the anterior portion of the optic nerve as a result of insufficient blood supply (ischemia). This form of ischemic optic neuropathy is generally categorized as two types: arteritic AION, in which the loss of vision is the result of an inflammatory disease of arteries in the head called temporal arteritis, and non-arteritic AION, which is due to non-inflammatory disease of small blood vessels. It is in contrast to posterior ischemic optic neuropathy, which affects the retrobulbar portion of the optic nerve.

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Non-arteritic anterior ischemic optic neuropathy (NAION) is a medical condition characterized by loss of vision caused by damage to the optic nerve as a result of ischemia, or insufficient blood supply. The key symptom of NAION is optic disc swelling, which typically resolves within 2 months, but often leads to optic atrophy. The likelihood of vision improvement after developing this condition is low.

References

  1. Bradford, Cynthia A. (2004). Basic ophthalmology (8th ed.). San Francisco: American Academy of Ophthalmology. pp. Chapter 2. ISBN   1560553618.
  2. Oria, Veronica. "Ischemic Optic Neuropathy: Abstract." Seminars in Neurology and By Monica Rodriguez Fontal, John B. Kerrison, and Reinaldo Garcia. N.p.: Thieme, 2007. N. pag. Print.
  3. 1 2 "Chapter 7: Ischemic Optic Neuropathy." Walsh and Hoyt's Clinical Neuro-ophthalmology. Ed. Neil R. Miller, Frank Burton Walsh, and William Fletcher Hoyt. Illustrated ed. Vol. 1. N.p.: Lippincott Williams & Wilkins, 2005. N. pag. Print.
  4. Oria, Veronica. "Ischemic Optic Neuropathy: Abstract." Seminars in Neurology. By Monica Rodriguez Fontal, John B. Kerrison, and Reinaldo Garcia. N.p.: Thieme, 2007. N. pag. Print.