To the Editor.
—Regarding the publication by the Ischemic Optic Neuropathy Decompression Trial (IONDT) Research Group,1 it seems noteworthy that 72% of the surgically treated patients in this trial were treated more than a week after onset of symptoms. No one was treated within the first 24 hours. Given that the window of opportunity for treatment of acute ischemic cerebrovascular disease is probably 6 hours or less, one wonders whether the treatment is truly ineffective or whether it was simply applied much too late.
Smith DB. Ischemic Optic Neuropathy Decompression Trial. JAMA. 1995;274(8):612. doi:10.1001/jama.1995.03530080028032