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Ischemic Optic Neuritis
Aka: Ischemic Optic Neuritis, Ischemic Optic Neuropathy, Anterior Ischemic Optic Neuropathy, Non-arteritic Ischemic Optic neuropathy, Optic Arteriolar Sclerosis
- See Also
- Giant Cell Arteritis (Arteritic Ischemic Optic Neuropathy)
- Pathophysiology: Non-arteritic Ischemic Optic neuropathy
- See Giant Cell Arteritis or Temporal Arteritis for Arteritic Ischemic Optic Neuropathy
- Arteriolar sclerosis causing gradual Occlusion of posterior ciliary arteries
- Types
- Arteritic Ischemic Optic Neuropathy
- See Giant Cell Arteritis (Temporal Arteritis)
- Non-arteritic Ischemic Optic neuropathy
- Arteriolar sclerosis (see risk factors below)
- Epidemiology
- See Giant Cell Arteritis
- Onset after age 40 years in those with Cardiac Risk Factors (see below)
- Risk Factors: Non-arteritic Ischemic Optic neuropathy (arteriolar sclerosis)
- Diabetes Mellitus
- Hypertension
- Hyperlipidemia
- Tobacco Abuse
- Symptoms
- Acute painless, irreversible Vision Loss
- Non-arteritic Ischemic Optic neuropathy
- No systemic symptoms
- Arteritic Ischemic Optic Neuropathy
- See Giant Cell Arteritis
- Signs
- Central vessel changes
- Optic disc edema
- Ischemic Iritis
- Large blind spot
- Management
- Urgent Ophthalmology referral
- Arteritic Ischemic Optic Neuropathy
- See Giant Cell Arteritis
- High dose Corticosteroids immediately (do not wait for temporal artery biopsy)
- Prednisone 2 mg/kg/day or Methylprednisolone 250 mg every 6 hours IV
- Goal is to preserve other, healthy eye
- Non-arteritic Ischemic Optic neuropathy
- Corticosteroids are also indicated immediately
- Discuss with ophthalology
- Cardiovascular Risk Factor modification
- References
- Trobe (2012) Physician Guide to Eye Care, p. 141-3