PPW ( black arrows ) and concentric RF ( white arrows ) present at presentation are still present at 3 weeks but have resolved at 7 weeks. Note the concentric RF extend to the macula at presentation. [iovs.arvojournals.org]

Our patient presented with a case of AION where the fall in perfusion pressure to the optic nerve was caused by cardiovascular shock. [aaopt.org]

CLINICAL PRESENTATION The classic presentation is a sudden, painless loss of vision in one eye present on awakening without premonitory symptoms. [onlinelibrary.wiley.com]

There was a swelling of the left optic disk, and a left relative afferent papillary defect (RAPD) was present. The right eye remained normal. The rest of the cranial nerves were normal, and no other neurologic deficits were present. [ajnr.org]

• Inflammation

  The inflammation is due to a condition known as giant cell arteritis (GCA) or temporal arteritis, which causes inflammation of medium- and large-sized arteries. [my.clevelandclinic.org]

  Blockage can occur with inflammation of the arteries (called arteritic, typically as part of a disorder called giant cell arteritis) or without inflammation of the arteries (called nonarteritic). [msdmanuals.com]

  The arteritic type is less common (25 percent) and associated with inflammation of blood vessels. [healthcentral.com]

• Unconsciousness

  Symptoms There is a sudden and painless deterioration of vision, usually discovered on waking in the morning. [43, 44] In eyes where the visual field defect bisects the fixation point, the patient may complain of intermittent blurred vision because of unconscious [ijo.in]

• Hypotension

  The role of nocturnal arterial hypotension in the pathogenesis of NA-AION and management of nocturnal hypotension is discussed. [ijo.in]

  Optic nerve enhancement in hypotensive ischemic optic neuropathy. J Neuroophthalmol. 2004;24:235-236. Rizzo JF 3rd, Andreoli CM, Rabinov JD. [appliedradiology.com]

  It is due to too long a period of hypotension, complicated by hemodilution, and orbital and eye swelling including chemosis. [news-medical.net]

  A Marcus Gunn pupil may not be present in bilateral NAION as seen in patients with postoperative hypotension. [onlinelibrary.wiley.com]

• Myalgia

  […] and CRP Tests for other systemic predisposing factors Temporal artery biopsy The arteritic and non-arteritic types of AION may be distinguished by the presence of the following in the former: The history of systemic symptoms such as jaw claudication, myalgia [news-medical.net]

  ] Since arteritic AION is similar in presentation to non-arteritic AION, patients over the age of 50 diagnosed with NAION must be evaluated to exclude AAION (symptoms: painful jaw muscle spasms, scalp tenderness, unintentional weight loss, fatigue, myalgias [en.wikipedia.org]

   Patients with the arteritic form usually note other symptoms of the disease –  headache (most common),  jaw claudication, and  temporal artery or scalp tenderness  Malaise, anorexia, weight loss, fever, proximal joint arthralgia, and myalgia also [slideshare.net]

• Blurred Vision

  She described increasingly blurred vision and presented to the emergency department on her fourth day of symptoms primarily because of sudden worsening of headache. [ajnr.org]

  Patients presented with blurred vision and loss of visual field. 15 In addition, most patients were found to have crowded disc as a risk factor along with various cardiovascular diseases, which are considered to be risk factors for both NAION and ED. [uspharmacist.com]

  Ocular Symptoms There is a sudden and painless deterioration of vision, usually discovered on waking in the morning. [43, 44] In eyes where the visual field defect bisects the fixation point, the patient may complain of intermittent blurred vision because [ijo.in]

• Visual Impairment

  Clinical Features  AION presents with rapid onset of painless, unilateral visual loss manifested by decreased visual acuity, visual field, or both.  The level of visual acuity impairment varies widely, from minimal loss to no light perception, and the [slideshare.net]

  There is up to a 15% chance of fellow eye involvement at 5 years. 14, 15 The VA and VF defect in a patient with prior NAION cannot directly predict the prognosis of visual impairment if there is second eye involvement. 12, 13 This presentation of optic [dovepress.com]

• Visual Impairment

  Clinical Features  AION presents with rapid onset of painless, unilateral visual loss manifested by decreased visual acuity, visual field, or both.  The level of visual acuity impairment varies widely, from minimal loss to no light perception, and the [slideshare.net]

  There is up to a 15% chance of fellow eye involvement at 5 years. 14, 15 The VA and VF defect in a patient with prior NAION cannot directly predict the prognosis of visual impairment if there is second eye involvement. 12, 13 This presentation of optic [dovepress.com]

• Marcus-Gunn Pupil

  A Marcus Gunn pupil may not be present in bilateral NAION as seen in patients with postoperative hypotension. [onlinelibrary.wiley.com]

• Stroke

  Posterior ischemic optic neuropathy is an uncommon type of neuropathy and diagnosis depends largely upon exclusion of other causes, chiefly stroke and brain tumor. [healthcentral.com]

  A stroke of the optic nerve is not related to a stroke occurring in the brain; therefore it is not accompanied by any weakness or paralysis. [eyeassociates.com]

  An “eye stroke” is a term used to describe several different conditions that lead to vision loss because of poor blood flow to the eye. Only some of these conditions occur by similar mechanisms as brain strokes. [pennmedicine.org]

  The usefulness of diffusion imaging in acute brain stroke is that it can predict the presence of significant brain ischemia within minutes of the onset of ischemic injury. [ajnr.org]

A carotid workup is generally not indicated in typical NAION but can be considered in the presence of ocular ischemic syndrome, retinal emboli, or transient neurological deficits. 19 OCT can be used to monitor the disease course for long term with the [dovepress.com]

Prompt treatment does not restore lost vision in the affected eye but protects the unaffected eye. Inadequate treatment risks relapses and additional vision loss. [merckmanuals.com]

1 Effect of Levodopa-Carbidopa on Visual Function in Patients With Recent-Onset Nonarteritic Anterior Ischemic Optic Neuropathy Completed NCT00432393 Phase 4 levodopa-carbidopa 2 Dalfampridine Treatment for Nonarteritic Anterior Ischemic Optic Neuropathy [malacards.org]

Justin O’Day, who, after reading the information, encouraged me to go to Germany for treatment. Approximately six months later, Dr. Fedorov contacted me and invited me to Germany for the treatment. I remain forever grateful to Dr. [restorevisionclinic.com]

[…] patients opted for no treatment. [reviewofophthalmology.com]

Treatment and Prognosis Treatment for ischemic optic neuropathy and the overall prognosis is dependent upon the type of ION that has been diagnosed. [southeasternretinaspecialists.com]

Sign in Published on Jun 18, 2015 A new review article covers the diagnosis, pathophysiological features, and prognosis of ischemic optic neuropathy, a relatively common cause of visual loss in older patients, including visual loss after cardiac surgery [youtube.com]

This article reviews the diagnosis, pathophysiological features, and prognosis of ischemic optic neuropathy, a relatively common cause of visual loss in older patients, including visual loss after cardiac surgery. [nejm.org]

Visual prognosis tends to be poor. Give corticosteroids if giant cell arteritis is possible. Drug Name Select Trade tocilizumab ACTEMRA prednisone RAYOS amiodarone CORDARONE aspirin No US brand name Click here for Patient Education [merckmanuals.com]

Visual prognosis tends to be poor. Give corticosteroids if giant cell arteritis is possible. Click here for Patient Education [msdmanuals.com]

In our patient, MR imaging served as a confirmatory test following the clinical diagnosis of ION and aided in the exclusion of other etiologies, such as multiple sclerosis or embolic infarcts. [appliedradiology.com]

Other possible causes of macular star include hypertensive retinopathy, papilledema, anterior ischemic optic neuropathy, diabetic papillopathy, and toxic etiologies. [medical-dictionary.thefreedictionary.com]

Although the mechanism is the same as the more classical presentation of non-arteritic AION, its etiology remains a distinct clinical entity. [aaopt.org]

Its etiology is unknown and no medical therapy has been proven effective in treating this condition. [cochrane.org]

There are two distinct sources of arterial supply for the two parts of the nerve head, according to which the lesions are classified, as well as based upon the etiology. [news-medical.net]

The most recent information concerning epidemiology, pathophysiology, and management was included in the review. [tandfonline.com]

Optic Neuropathy (NAION) Official Title The Detection and Epidemiology of NAION in a Commercially Insured Population in the United States. [pfizer.com]

The epidemiological studies have rarely been addressed and according to Kobayashi et al., the prevalence in Japan is 1.47 per 100 000 [ 4 ]. [bmcophthalmol.biomedcentral.com]

[…] administration 34 A Prospective Case-crossover Study to Evaluate the Possible Association Between the Use of PDE5 Inhibitors and the Risk of Acute Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) Completed NCT01131104 PDE5 Inhibitors 35 The Detection and Epidemiology [malacards.org]

From an epidemiologic point of view, the lower the blood pressure, the fewer the cardiovascular events observed; however, there is a suggestion that strokes and blindness may increase uncommonly in elderly people who experience an excessive decline in [onlinelibrary.wiley.com]

The most recent information concerning epidemiology, pathophysiology, and management was included in the review. [tandfonline.com]

Sign in Published on Jun 18, 2015 A new review article covers the diagnosis, pathophysiological features, and prognosis of ischemic optic neuropathy, a relatively common cause of visual loss in older patients, including visual loss after cardiac surgery [youtube.com]

This article reviews the diagnosis, pathophysiological features, and prognosis of ischemic optic neuropathy, a relatively common cause of visual loss in older patients, including visual loss after cardiac surgery. [nejm.org]

The pathophysiology behind NAION is an idiopathic ischemic process. [onlinelibrary.wiley.com]

DWI has played a central role in the assessment of acute ischemic insults to the brain, and there are reports of diffusion positive ischemic lesions in the spinal cord. 10 Because the optic nerve is an extension of the CNS as is the spinal cord, the pathophysiology [ajnr.org]

Biousse reports receiving consulting fees from GenSight Biologics and grant support from Research to Prevent Blindness; and Dr. [nejm.org]

Surgical PION is still an enigma at present with respect to its treatment, and care should therefore be taken to prevent its occurrence. [news-medical.net]

Finding and treating the problem as soon as possible can help prevent further vision loss from ION. [aao.org]

Although it is not proven, some specialists will recommended a daily aspirin, good control of blood pressure (neither too high or too low), good diabetic control, and treatment for sleep apnea to help prevent the involvement of the second eye. [neec.com]

Increasing perfusion of the optic nerve may reduce damage and prevent progression. Reduction in intraocular pressure has been shown to increase optic disc perfusion in animal models. [clinicaltrials.gov]