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Article
August 23, 1995

Ischemic Optic Neuropathy Decompression Trial-Reply

Author Affiliations

IONDT Study Group University of Maryland Baltimore

JAMA. 1995;274(8):612. doi:10.1001/jama.1995.03530080028033
Abstract

In Reply.  —The IONDT was designed to evaluate the safety and efficacy of optic nerve decompression surgery in the management of ischemic optic neuropathy. When the study design was submitted for peer review, the procedure had already gained wide acceptance in the ophthalmic community. This was based on empirical evidence that vision improved when optic nerve decompression surgery was performed within 30 days of the onset of symptoms.1-3 The focus of our study was to evaluate the procedure as it was being practiced in the community and to determine by careful clinical follow-up whether or not it was efficacious and safe.Dr Smith's suggestion that surgery begin within hours of symptoms is theoretically a good one. The IONDT did shorten the time interval for eligibility to 14 days, precisely because we wanted to maximize the likelihood that intervention would improve optic nerve function. We believed that in an ischemic

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