Anterior Ischemic Optic Neuropathy

Hayreh, Sohan Singh; Zahoruk, Ronald M.

doi:10.1159/000309084

Cited by 58 publications

(7 citation statements)

References 5 publications

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“…During the initial stages, the optic disc edema is usually (but not always) associated with characteristic prominent, dilated and frequently telangiectatic vessels over the disc, and peripapillary retinal hemorrhages that are much more numerous than in non-diabetics[4142] [Fig. 8a and c].…”

Section: Clinical Features Of Various Types Of Ischemic Optic Neuropamentioning

confidence: 99%

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Management of ischemic optic neuropathies

Hayreh

2011

Indian J Ophthalmol

127

146

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Ischemic optic neuropathies (IONs) consist primarily of two types: anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). AION comprises arteritic AION (A-AION: due to giant cell arteritis) and non-arteritic AION (NA-AION: due to other causes). PION consists of arteritic PION (A-PION: due to giant cell arteritis), non-arteritic PION (NA-PION: due to other causes), and surgical PION (a complication of several systemic surgical procedures). These five types of ION are distinct clinical entities etiologically, pathogenetically, clinically and from the management point of view. In the management of AION, the first crucial step with patients aged 50 and over is to identify immediately whether it is arteritic or not because A-AION is an ophthalmic emergency and requires urgent treatment with high-dose steroid therapy to prevent any further visual loss in one or both eyes. Patients with NA-AION, when treated with systemic corticosteroid therapy within first 2 weeks of onset, had significantly better visual outcome than untreated ones. Systemic risk factors, particularly nocturnal arterial hypotension, play major roles in the development of NA-AION; management of them is essential in its prevention and management. NA-PION patients, when treated with high-dose systemic steroid therapy during the very early stages of the disease, showed significant improvement in visual acuity and visual fields, compared to untreated eyes. A-PION, like A-AION, requires urgent treatment with high-dose steroid therapy to prevent any further visual loss in one or both eyes. There is no satisfactory treatment for surgical PION, except to take prophylactic measures to prevent its development.

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Section: Clinical Features Of Various Types Of Ischemic Optic Neuropamentioning

confidence: 99%

“…(a, c) Optic disc edema with marked telangiectatic vessels on the optic disc, multiple punctate peripapillary hemorrhages; (b, d) no edema, no abnormal vessels on the disc, and no peripapillary retinal hemorrhages on resolution[41]…”

Section: Clinical Features Of Various Types Of Ischemic Optic Neuropamentioning

confidence: 99%

Management of ischemic optic neuropathies

Hayreh

2011

Indian J Ophthalmol

127

146

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“… Anterior ischemic optic neuropathy 17–22 (80‐90%) Amaurosis fugax 23 (10 − 20%) Diplopia and ophthalmoplegia 11 , 12 (10 − 15%) Central retinal or branch artery occlusion resulting in visual loss 24 (17%) Retrobulbar ischemic optic neuropathy (rare) Horner's syndrome Visual hallucinations 23 …”

Section: Discussionmentioning

confidence: 99%

Bilateral Internuclear Ophthalmoplegia: An Initial Presenting Sign of Giant Cell Arteritis

Ahmad

Zaman

1999

J American Geriatrics Society

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A 63-year-old man presented six days after the sudden onset of horizontal double vision. His left eye became divergent two days later. On initial examination he had bilateral internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was weak but there were no other neuro-ophthalmic signs. Constitutional signs included confusion and unsteadiness on his feet. A provisional diagnosis of arteritis was made. His ESR was 92 mmlh and a superficial temporal artery biopsy confirmed the diagnosis of giant cell arteritis. After two weeks or oral prednisolone his eye movements returned to normal. There have been no further relapses. This would appear to be a unique presentation of giant cell arteritis. The causes of internuclear ophthalmoplegia are discussed along with a review of the ocular and neuro-ophthalmic signs of giant cell arteritis.

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“…The pathophysiology of the condition is debated but the prevailing hypothesis is that it is due to venous congestion at the optic nerve head in individuals with susceptible anatomy . So‐called ‘diabetic papillopathy’ is a variant of NAION in patients with diabetes . This condition usually occurs in a younger age group than the typical NAION demographic .…”

Section: The Metabolic Syndrome and The Eyementioning

confidence: 99%

Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease

Kearney

Fagan

Al-Qureshi

2014

Clinical Exper Ophthalmology

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This review examines the current evidence of the relationship between sugar consumption and the development of retinal and other eye diseases including diabetic retinopathy, hypertensive retinopathy, age-related macular degeneration, non-arteritic anterior ischaemic optic neuropathy and cataract. Sucrose is comprised of fructose and glucose. Sugar consumption has increased five-fold over the last century, with high quantities of sucrose and high-fructose corn syrup found in processed food and soft drinks. This increased consumption is increasingly recognized as a central factor in the rapidly rising rates of obesity and type 2 diabetes. The body metabolizes fructose and glucose differently, with fructose appearing to have the greater propensity to contribute to the metabolic syndrome. This review examines the effect of high rates of dietary consumption of refined carbohydrates on the eye, including the effect of chronic hyperglycaemia on microvascular disease in diabetic retinopathy, and the pathophysiological changes in the retinal circulation in hypertensive retinopathy.

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Anterior Ischemic Optic Neuropathy

Cited by 58 publications

References 5 publications

Management of ischemic optic neuropathies

Management of ischemic optic neuropathies

Bilateral Internuclear Ophthalmoplegia: An Initial Presenting Sign of Giant Cell Arteritis

Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease

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