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March 1995

Surgery for Ischemic Optic Neuropathy

Author Affiliations

Boston, Mass

Arch Ophthalmol. 1995;113(3):273-274. doi:10.1001/archopht.1995.01100030027015

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ANTERIOR ISCHEMIC optic neuropathy, like mitral valve prolapse or galactorrheaamenorrhea from pituitary microadenomas, is one of those disorders that must have always been with us but that was hardly known as recently as 35 years ago. We now recognize that anterior ischemic optic neuropathy may have a higher incidence than any other optic neuropathy except for glaucoma and is the leading cause of disc swelling in late life. The average annual incidence has been estimated as 3.25 cases per 100 000 population over age 60 years.

Anterior ischemic optic neuropathies come in two varieties: arteritic and nonarteritic. The arteritic cases are almost all consequent to temporal arteritis and result from occlusion of posterior ciliary arteries. Visual loss in temporal arteritis can often be prevented, but, once it occurs, treatment is largely ineffective and spontaneous improvement does not occur. Most cases of anterior ischemic optic neuropathy, however, are nonarteritic, a disorder

Sergott RC, Cohen MS, Bosley TM, Savino PJ.  Optic nerve decompression may improve the progressive form of nonarteritic ischemic neuropathy . Arch Ophthalmol . 1989;107:1743-1754.Article
The Ischemic Optic Neuropathy Decompression Trial Research Group.  Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful: results of the Ischemic Optic Neuropathy Decompression Trial (IONDT) . JAMA . 1995;273:625-632.Article