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Anterior Ischemic Optic Neuropathy

 Syn. AION

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]
Peripapillary splinter hemorrhages #Nonarteritic
Note: Nonarteritic Anterior Ischemic Optic Neuropathy
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosi] Vaughan [ 643]
Hyperemic optic disc edema #Nonarteritic
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] BCSC [ 99]

Lab / Serology

 Raised C-reactive protein #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]
Elevated platlet count #Arteritic
Note: Arteritic AION
Ref: BCSC [ 99]
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]

Imagin Study

 Central retinal artery occlusion
Note: Arteritic Anterior Ischemic Optic Neuropathy due to giant cell arteritis
Ref: Vaughan [ 645]
Cilioretinal artery occlusion
Note: Arteritic Anterior Ischemic Optic Neuropathy due to giant cell arteritis
Ref: Vaughan [ 645]
Diffuse ocular ischemia
Note: Arteritic Anterior Ischemic Optic Neuropathy due to giant cell arteritis
Ref: Vaughan [ 645]

Complication

Risk Factors

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

Cause

 Thrombosis of the short posterior ciliary arteries
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] Vaughan [ 642]
Carotid dissection #Non-arteritic_type
Note: Non-arteritic type
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] Vaughan [ 642] BCSC [ 101]
Decreased perfusion of the short posterior ciliary arteries #Non-arteritic_type
Note: Non-arteritic type, due to Emboli, due to carotid dissection
Ref: Uptodate [ Nonarteritic anterior ischemic optic neuropathy: Clinical features and diagnosis] Vaughan [ 642] BCSC [ 101]

Other