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March 1973

Acute Optic Neuropathy in Older Patients

Arch Neurol. 1973;28(3):182-185. doi:10.1001/archneur.1973.00490210062008

Forty-eight patients over the age of 35 years were examined and followed after the sudden spontaneous loss of vision referable to one or both optic nerves. Patients with multiple sclerosis were excluded. Men and women were equally affected, most often between the ages of 55 to 65 years. Both optic nerves were involved simultaneously in nine (19%) patients and eventually in 23 (48%), but multiple lesions in a single optic nerve occurred only twice. Visual acuity remained normal in 21 (35%) of involved eyes. When acuity was impaired, it eventually improved in 13 (33%), especially when the defect in the visual field was a central scotoma or small altitudinal scotoma. Large arcuate defects and altitudinal hemianopias were much more common, but stable. Despite high prevalence of systemic vascular disease, signs and symptoms of cerebrovascular disease were rare. No evidence of expanding intracranial lesions was found.