Management of Non-arteritic Anterior Ischemic Optic Neuropathy

Intravitreal erythropoietin injection for the treatment of non-arteritic anterior ischaemic optic neuropathy

“…Therefore, different treatment modalities have been suggested based on presumed pathogenic mechanisms 1 4 5 10 21. Other than systemic steroids, none of the proposed treatments have been shown to be beneficial in adequately large patient populations 5.…”

“…Although the exact pathogenesis of NAION is not known, predisposing factors include constriction of neuronal tissue in small cupless discs (disc at risk), arterial hypertension, arteriosclerosis and diabetes mellitus 1 2. One theory points to nocturnal arterial hypotension causing ischaemia and resultant swelling of the axons, and thus increased pressure on the neuronal tissue confined within the tight borders of the posterior scleral outlet.…”

“…There is no widely accepted treatment for NAION despite the continued research in past decades 1 4 5…”

Bilateral anterior ischemic optic neuropathy after bilateral neck dissection

“…Small cup-to-disc ratio or absence of excavation and optic disc drusen are ocular risk factors associated with AION. 13,14 Arterial hypertension, nocturnal arterial hypotension, diabetes mellitus, ischemic heart disease, and other cardiovascular disorders, hyperlipidemia, atherosclerosis, and arteriosclerosis are considered systemic risk factors. 14,15 On the other hand, all published cases of perioperative AION have affected both eyes, often occurring in otherwise healthy patients; it is attributed to a combination of hypovolemia, hemodilution, systemic hypotension, anemia, prone position, and pre-existing cardiovascular disease.…”

Non-arteritic Anterior Ischemic Optic Neuropathy: Role of Systemic Corticosteroid Therapy

“…Kaderli et al [35], in four eyes, reported visual acuity improvement, but without any improvement in visual fields. However, the study of Kaderli et al [35] has some notable flaws which are discussed in detail elsewhere [19]. For example: (a) their study is based on only four eyes, (b) large natural history studies [28,40] have shown spontaneous visual acuity improvement in 41% of eyes with NA-AION, and (c) more importantly, all the eyes in the study by Kaderli et al [35] showed no improvement in visual fields and all had altitudinal visual field defects.…”