Optic Nerve Head Infarction

Abstract

We studied vascular concomitants and performed systematic carotid and ophthalmic Doppler ultrasounds, ECG and echocardiography in 50 consecutive patients older than 50 years with nonarteritic optic nerve head infarction (ONHI). Hypertension (58%) and diabetes (30%) were common, but a potential cardiac source of embolism was rare (6%). Large-artery disease was present in only 4 patients who also had watershed cerebral infarct simultaneous to ONHI and ipsilateral to an occluded internal carotid artery. Ophthalmic artery flow was asymmetrical only in the patients with carotid occlusion. These findings suggest that small-artery disease is the leading cause of ONHI, while large-artery disease and cardioembolism are almost never responsible for isolated ONHI.