A 74-year-old man presented with bilateral optic nerve atrophy related to arteritic anterior ischaemic optic neuropathy (AION) which started 22 years ago. Atrophic papilla was noted in both eyes and optical coherence tomography showed thinning of the retinal nerve fibres layer as well as the macular ganglion cell complex. Optical coherence tomography angiography of the macula found a decreased density of the superficial capillary complex, whereas deep capillary complex was well-preserved. Inner retinal layer atrophy in chronic arteritic AION is followed by a loss of vascularisation in these layers as a consequence of the neurodegeneration.

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