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Ischemic Optic Neuropathy

Signs & Symptoms

 Acute loss of vision
Note: Occurring over hours to days
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] Vaughan [ 642] BCSC [ 99]
Pain on ocular movement (negative symptom)
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 101]
Transient prodromal diplopia
Note: More common in giant cell arteritis than in NAION
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 99]
Transient prodromal vision loss
Note: More common in giant cell arteritis than in NAION
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 99]

Physical Examination

 Acute loss of vision
Note: Occurring over hours to days
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] Vaughan [ 642] BCSC [ 99]
Hyperemic optic disc edema #Nonarteritic
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 99]
Unilateral
Note: Nonarteritic Anterior Ischemic Optic Neuropathy,Posterior ischemic optic neuropathy
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis, Posterior ischemic optic neuropathy] Vaughan [ 643] BCSC [ 99]

Lab / Serology

 Disruption of the internal elastic lamina #Arteritic
Note: Temporal artery biopsy, Arteritic Anterior Ischemic Optic Neuropathy,arteritic posterior ischemic optic neuropathy
Ref: Uptodate [ Diagnosis of giant cell arteriti, Posterior ischemic optic neuropathys] Vaughan [ 645]
Raised Erythrocyte sedimentation rate #Arteritic
Note: Arteritic Anterior Ischemic Optic Neuropathy,arteritic posterior ischemic optic neuropathy
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis, Posterior ischemic optic neuropathy] Vaughan [ 645] BCSC [ 99]
Inflammatory cell infiltration #Arteritic
Note: Temporal artery biopsy, Arteritic Anterior Ischemic Optic Neuropathy,arteritic posterior ischemic optic neuropathy
Ref: Uptodate [ Diagnosis of giant cell arteriti, Posterior ischemic optic neuropathys] Vaughan [ 645]

Imagin Study

 Enhancement of the optic nerve (negative symptom)
Note: 95 percent of patients with optic neuritis will demonstrate gadolinium contrast enhancement of the optic nerve, this is relatively unusual (<10 percent) in NAION
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 101]

Complication

Risk Factors

 Smoking
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Epidemiology, pathogenesis, and etiologies, Posterior ischemic optic neuropathy]

Cause

 Cardiac surgery #Nonarteritic
Note: Posterior Ischemic Optic Neuropathy,non arteritic anterior ischemic optic neuropathy
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Epidemiology, pathogenesis, and etiologies, Posterior ischemic optic neuropathy] Vaughan [ 646] BCSC [ 101]
Vasculitis
Note: Arteritic anterior ischemic neuropathy,Posterior Ischemic Optic Neuropathy
Ref: Uptodate [ Posterior ischemic optic neuropathy] Vaughan [ 646] BCSC [ 99]
Nonocular surgery #Nonarteritic
Note: Particularly lumbar spine surgery in the prone position or cardiac surgery, Posterior Ischemic Optic Neuropathy,non arteritic anterior ischemic optic neuropathy
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Epidemiology, pathogenesis, and etiologies, Posterior ischemic optic neuropathy] Vaughan [ 646] BCSC [ 101]

Other