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—Drs Ellenberger and Lavin have emphasized a major dilemma that also concerned us when we reported the results of our study. Our data indicate that while the general population has a risk of cerebral infarction that is less than 1% per year, a population of patients with nonarteritic AION seems to have a risk that is at least three times (3%) higher per year. Given these statistics, one must consider whether anything can be done to lower the risk of cerebral infarction in this (or any) group of patients. We certainly agree with Ellenberger and Lavin that not all vascular lesions that cause cerebrovascular attacks are treatable by endarterectomy, and we are, of course, aware of the controversy regarding the treatment itself. It is for this reason that we did not recommend either cerebral angiography or endorse endarterectomy in our article, even though in selected patients these procedures
Guyer DR, Miller NR, Auer CL, Fine SL. The Role of Carotid Endarterectomy in Ischemic Optic Neuropathy-Reply. Arch Ophthalmol. 1985;103(11):1634. doi:10.1001/archopht.1985.01050110027012